Is Graft Needed for Rhinoplasty?

I have heard from people and read online about a graft used during Rhinoplasty. If I only need my nose to be reduced in size--the bone, the cartilage, and the alar base-- do I really need a graft to be put in place?

Doctor Answers (10)

Need for graft in rhinoplasty depends on presenting issues

+1

There are many different cartilage graft options for use inside the nose in regards to reconstructive and cosmetic purposes. Most primary noses where there is a reduction in cartilage do not need cartilage grafting placed for the rhinoplasty. It all depends on the presenting issues.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Grafting In Rhinoplasty

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Rhinoplasty involves reshaping the nose, and depending on what type of reshaping is done will determine which (if any) grafts are needed. Typically, cartilage from the septum is used to straighten, strengthen, or rebuild the nasal framework. With open rhinoplasty, the tip usually is supported with cartilage graft (columellar strut) in the column of tissue that separates one nostril from the other.

Cartilage grafts are beneficial because they help maintain the operative result over the long run. The need for cartilage grafts is something that must be determined on an individual basis.

C. Spencer Cochran, MD
Dallas Facial Plastic Surgeon
5.0 out of 5 stars 91 reviews

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Grafts are optional

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Rhinoplasty may include placement of grafts at the time of the intial surgery. They are frequently used when doing revision rhinoplasty. If a nose that is slightly large with a round tip it is reasonable to not include any grafts. If a graft is suggested and you have concerns about it you should discuss with the surgeon the purpose of the graft and how it will help your result... When having or contemplating plastic surgey knowlege is important and fear is normal but not usually helpful throgh the process.

Richard Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

Don't sweat the irrelevant.

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Grafts are neither good nor bad. They are one of many options a surgeon has at his/her disposal when reshaping someone's nose. But this should not be a concern of the patient. Here's why:

From the surgeon's perspective, when to use a graft(s), which ones to use (strut, cap, tip, buttress, spreader, rim, alar batten, columellar plumping, radix, camouflage, etc.), and what material to fashion them from (septum, ear, rib, calvarium, etc.) are all important questions.

But from the patient's perspective, the discussion can actually be distracting from the more important things: does the surgeon understand what you want, do the pre-op morphs reflect your aesthetics, do you have rapport with the surgeon, does the surgeon have the right qualifications, does his/her before and after photos reflect quality work?

Ask 10 rhinoplasty surgeons how they'd approach a given patient's goals and you'll get 10 different answers...truly! But in the end, the question is whether the surgeon can meet that goal with his/her personal approach.

All the best,

--DCP

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Grafts can be both good and bad

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When properly selected, grafts in rhinoplasty can help to ensure long term results and better outcomes. That being said, I only use grafts in about 30-50% of the noses that I do. I do predominantly closed Rhinoplasty, which reduces the number of grafts that can be placed, due to the nature of the operation itself. Most noses do not really need structural grafts, provided that a conservative operation is performed. Flat and poorly developed noses and those with droopy tips tend to required grafts in order to support, project, and narrow the nose.

Grafts that are typically used include columellar struts (for poorly supported tips), onlay or spreader grafts (for deviated noses) and radix grafts (for shallow nasal bones). In the right patients, these grafts can mean the difference between an OK result and a great one.

Rather than thinking about the specifics of your personal rhinoplasty operation, you should seek a surgeon that has results you like. Chances are that, if their aesthetic sense and prior outcomes match your taste, you will get the result you want; regardless of the technique that is used.

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Graft for Rhinoplasty depends

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No one can really give you the answer until they see what you look like and understand your expectations regarding the final result. Sometimes, grafts are needed when a nose is reduced in size, but this is not typical.

Plan on seeing a few doctors.

Michael Kulick, MD
San Francisco Plastic Surgeon
2.5 out of 5 stars 3 reviews

Possibly.

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 Grafts are used to give support as well as to fill depressions. This is true even when we are making noses smaller. We usually can get the graft material from the septum.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Grafts are almost always needed to get the best results

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Every rhinoplasty is as different as there are people. Even when the nose appears too big grafts are frequently need to cover up the look of crookedness or bumpiness of the dorsal shape of the nose. Also there often grafts used to support the mid vault of the nose and when the tip of the nose is reshaped grafts are often used to support or to lengthen the nose. It all depends on what your nose looks like and what the supports of the nose are doing.

Carl W. 'Rick' Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 11 reviews

Graft for the nose

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No. Most likely given that you are not going for augmentation of your nose but reduction, you should not need any grafts from the ear. However despite reduction sometimes the nasal tip needs more definition and using some cartilage their can make a big difference. Typically those grafts can be obtained from the nasal septum cartilage without going to the ear.

Regards

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 25 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.