Revision Rhinoplasty Q&A
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Adding Another Layer of Autologus Material After Revision Rhinoplasty?

asked 2 years ago by pumpkin84 in Aisa
Latest answer by Michael Elam, MD
Question viewed 858 times
Tags: nose, nostrils, asymmetry, tip

I had my Rhinoplasty revision surgery 3 months ago to replace silicone implant with ear cartilage. My surgeon used my septal cartilage and ear cartilage to build my tip, and ear cartilage to augment my bridge. And the problem is, one side of my nostril is slanted while the other straight. And my nose does not look great at all with flat bridge and round nose tip. It was almost perfect to me at one month post op. It seems to me that my nose tip was shortened and more rounded during the healing (or even maybe reabsorption).

I want to add another layer of autologus material over my ear cartilage. Is it necessary to take out the ear cartilage and put it back again? I am afraid by the time when I do the revision surgery, the ear cartilage will already grow firmly with my nose bone and it will be traumatizing to my nose to seperate them by force.

Also, if I were to have a third surgery in future, will it be a danger that my nose is going to collapse? I heard that too many surgeries will make your nose weak and leading to collapse. Since my surgeon has already used my septal cartilage as a base to build my nose tip. Will my nose be prone to collapse? What will be the sign in terms of appearance when the nose is collapsing? Thank you.

Read my review "Revision to Replace Silicone Implant W/ear Cartilage"

7 answers to Adding Another Layer of Autologus Material After Revision Rhinoplasty?

+2

Wait until nose is fully healed to decide

As far as collapsing of the nose, this will not occur unless you sustain severe trauma to the nose. Collapsing of the nose will be most evident by a saddle nose deformity, which you obviously do not have at this point. This would show up immediately after the surgery if it were going to occur. I would not recommend removing and replacing any ear cartilage grafts unless they are causing severe problems in the nose because of the extent of revision rhinoplasty work that you have had done. ... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+2

You might benefit from an Injectable Filler treatment.

Revision rhinoplasty is one of the most challenging, and humbling operations I perform. It would be best if this surgery were your last, since your surgeon needed both ear, and septal cartilage after removing the silicone implant. You can have injectable fillers safely placed in your nose to correct minor assymetries that are visible at 3 months after rhinoplasty. I didn't get a clear picture of how your nose looks, or what's bothering you, so feel free to email me a full facial picture... more
Eric M. Joseph, MD

West Orange Facial Plastic Surgeon
+2

Revision rhinoplasty takes time to assess

You had revision rhinoplasty only three months ago so it is too early to assess the results. Most surgeons would wait a full year before considering re-operation. Operating before waiting that long makes no sense because it takes that long for the nose to fully heal, and sometimes longer. Complete healing means that the scar tissue has matured, the swelling has gone out of the nose, and the cartilage has been integrated into the tissues. Early on, the nose, especially the tip, often... more
Daryl K. Hoffman, MD

Los Gatos Plastic Surgeon
+1

Revision Rhinoplasty

It is to soon to assess any results and you must wait at least a year for any revision rhinoplasty surgery. Be patient and discuss the many options of autologous materials available with your surgeon. Best regards!
Michael Elam, MD

Orange County Facial Plastic Surgeon
+1

Revision Rhinoplasty

Hi Pumpkin, You should wait at least one year before having further revision surgery on your nose. You can have more autologous grafting material (other ear cartilage, fascia, rib cartilage). As long as your surgeon maintains adequate dorsal septal cartilage support, your nose should not be in danger of collapse. The main sign of nasal dorsal collapse is progressive lowering of the profile in the middle third of the nose. Good luck and be well. Dr. P
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+1

Allow time for current grafts to take

AS others have advised, I concur and beleive that you could cause more damage by intervening too soon. Give it time for the current cartilage to take. There are many different sources for autologous materals as mentioned: fascia, dermis, cartilage, etc.
Otto Joseph Placik, MD

Chicago Plastic Surgeon

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