Revision Rhinoplasty to Lengthen Nose with Either Ear or Rib Cartilage?

Hi I am considering revision rhinoplasty to lengthen an overly shortened nose. My concerns are whether in the experience of the Doctor's on Realself this is a realistically succesful procedure. For instance I've had consults and done as much of my own research as I can and what seems evident to me is that even in the hands of the most experienced surgeon that this is a challenging corrective surgery. My fear is that something I'm already unhappy with will be made worse.

Doctor Answers (4)

Revision rhinoplasty for an over-shortened nose

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You are right to be concerned with the degree of difficulty in revising an over-shortened nose. Beyond the usual problems with revision surgery, an over-shortened nose is complicated by the need to expand the skin/soft-tissue envelope of the nose yet avoid the resulting tension from distorting the surgical result.

If only a small amount of lengthening is required, then onlay grafts of cartilage at the tip, columella, and nostril margins may be adequate. There may also be a need for composite grafts of cartilage and skin to release the internal lining of the nose, too.

For more extensive correction, stiffer grafts such as rib cartilage are required. It will make the nose stiffer than natural, but it stands a better chance of maintaining a natural shape and not crumpling or twisting under the load of wound contraction.

All the best,

--DCP

Pearson Facial Plastic Surgery®


Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Revision Rhinoplasty to Lengthen Nose with Either Ear or Rib Cartilage?

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       If all of your septal cartilage that can be harvested has been utilized, I would use conchal cartilage grafts to create extension(for example depending upon what needs to be done) as a preference over rib graft.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 218 reviews

Revision Rhinoplasty to Lengthen Nose with Either Ear or Rib Cartilage?

+1

 You have made the correct assessment of the situation.  Photos, of your nose would help in the evaluation but lengthening the nose is indeed more complicated than shortening it with Revision Rhinoplasty.  Conchal ear cartilage placed along the nasal tip makes the nose appear longer/tip less over-rotated but this often needs to be combined with tucking of the columella.  Rib cartilage grafts are way to stiff for this region of the nose in my opinion. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

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Revision rhino concerns

+1

the stakes are high in revision rhinoplasty

seek someone with experience, go over photos

rib is usually needed if a septopalsty was done with the first surgery

Adam Bryce Weinfeld, MD
San Angelo Plastic Surgeon
5.0 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.