Revision Rhinoplasty: Q&A
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Rib and Fascia Vs Ear Cartilage to Fix a Scoop
I have a collapsed nasal valves,scooped bridge,and upturnrd tip from a primary rhino.I went on 2 consults for revision. One Dr suggested using ear cartilage to fix the scoop. Another suggested using irradiated donor cartilage that is ground up to a paste and temporal facia. Which method is favored and why?
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10 Doctor Answers |
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11704
in Lindenhurst
+1
You may be a candidate for a Non-Surgical Rhinoplasty to improve the "scooped" appearance of your nasal bridge. Video attached.
I read your concerns. If you have trouble breathing through your nose, you may indeed require Revision Rhinoplasty Surgery. If your breathing is not an issue, you would be surprised how much improvement you could see in the appearance of your nose after a well-performed Injectable Filler treatment. My personal preference is to use Silikon-1000, an off-label filler for permanent results.
Regards from West Orange.
see video
+4
Solid versus cartilage grafts for dorsal augmentation in revision rhinoplasty.
There are several options available to augment a deficient nasal bridge during revision rhinoplasty. Unfortunately, there is no consensus as to the best option. The preference of each surgeon depends on his or her personal bias and experience. When making a decision I would suggest getting as best informed as you can regarding all the possible options then seeking out a handful of opinions from experienced revision rhinoplasty surgeons. Ask them why they are making...
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"Best" Option for Augmenting the Nose is Diced Cartilage Wrapped in Fascia
What is the "Best" option for augmenting the nose?
You will not get agreement amongst surgeons to this question! With that caveat out of the way, I'll give you the opinion that I've held for more than 5 years: Diced Cartilage (your own cartilage) Wrapped in Fascia (your own fascia) is "the best" tissue or material available when a significant augmentation of the back of the nose is needed.
Advantages of Diced-Cartilage Grafts Wrapped in Fascia:
It...
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Rib cartilage likely your best choice
Using your own - not irradiated cartilage - is your best choice since it is structurally sound and will not reabsorb.
diced cartilage and fascia is a good option but it lacks any support if your nose needs to be lengthened
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Cartilage choice to fix a scooped nose
A scooped out bridge of the nose is always best treated with patient’s own cartilage. Nasal and septal cartilages are the best choice, but in the event of a cartilage depleted nose, ear cartilage is the second best choice. Rib cartilage is the third best choice. Another alternative is a small silastic implant which can be inserted as a synthetic implant if no cartilage is available. Radiated donor cartilage tends to have resorption problems and is not consistent...
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Rib cartilage for Rhinoplasty.
None of the above, IMHO. For over 20 years, of performing Rhinoplasty and Revision Rhinoplasty, I prefer to use materials that are reliable and predictable in Revision Rhinoplasty because the worst thing that can happen is the material placed begins to reabsorb. Rib cartilage, bone, and folded ear cartilage for nasal bridge augmentation can and does absorb..unevely after a number of years.
I like ear cartilage for nasal tip grafts because it's soft enough to look natural...
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Revision Rhinoplasty
Using ear cartilage or rib may be equally effective in correcting your nasal concerns. Different surgeons have different preferences regarding their choice of donor material. Some surgeons would argue that using your own rib is better than cadaver rib as well. The important question is how much cartilage is needed and is ear going to provide enough grafting material as well as how experienced your surgeon is in performing a complicated revision procedure.
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Best type of cartilage for revision rhinoplasty
Septal, ear and rib cartilage are all good sources of cartilage. Depending on the specific use some times may be better than others given their size and strength.
Some surgeons like to use a diced cartialge wrapped in fascia technique for augmenting the dorsum. I prefer using a patient's own cartilage that I then carve.
Fixing an upturned tip often requires strong, straight cartilage. The septum or ear are usually the best sources of cartilage for this purpose.
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Nasal Revision
I suggest septal, ear, or rib cartilage grafts to lengthen your nose, fix your collapsed valves,and correect the "scoop". Diced cartilage wrapped in fascia is an excellent technique to augment the dorsum.
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Rhinoplasty
There are many different ways to s"skin a cat" If you have a scooped nose, often a rib cartilage graft will offer the most cartilage to augment it. I am not a big fan of diced cartilage.
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