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Rib Graft Bridge and Tip... Crooked, What Are my Options?

asked 7 months ago by Sammie125 in New York, NY
Latest answer by Robert Kotler, MD
Question viewed 256 times
Tags: crooked, 2 months post-op, options, rib graft

I am 1.5 months post ops and it's very obvious that my rib graft is crooked from the Start of my bridge to the tip... Much to the left. Is the only option to have another surgery or can this be corrected some other ways? I am certain it's not from swelling as I can feeling the graft and see it very clearly that it's more left ..... Even wearing my glasses, I had the get adjusted because it doesn't fit right since the nose piece needs to be adjusted more to the left. 3 docs all agreed.

9 answers to Rib Graft Bridge and Tip... Crooked, What Are my Options?

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Rib Graft Bridge and Tip... Crooked, What Are my Options?

Sadly, no if after the initial post Rhinoplasty swelling subsides (within several months) and the rib grfat is truly crooked...a Revision Rhinoplasty would be required to modify the graft. IMHO, rib cartilage/bone as well as banked cartilage/bone all have the habit of dissolving unevenly over the years and for that reason I do not use this material for building up the nasal bridge. I would remove the rib graft and replace it with a straight silastic dorsal graft that's... more
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Revision rhinoplasty may be necessary, but you need to wait a bit.

Dear Sammie125; It is only 1-1/2 months since surgery and, while you claim that, “My rib graft is crooked from the start of my bridge to the tip,” wisdom suggests that you still wait a bit. Unless this looks absolutely grotesque and terrible, time may cause some improvement. In any event, it will also be a technically easier operation for your surgeon to do after some time has passed. Occasionally, some people are lucky to have a situation whereby a... more
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Crooked rib graft

Your graft may be crooked or it may be warped. You'll need to have it surgically adjusted. I doubt you will be happy with filler.
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Rib graft not straight after surgery

There are several reason for a rib graft to not be straight after surgery. The corection depends on the size and position of the graft. More often than not I prefer to allow the rib to attain some vascularity prior to correction. The answer in each case is somewhat different depending on the prior surgery ,the correction that is needed and the condition of the soft tissues.
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Crooked Graft Corrections.

You have one of three choices: 1) see if the abnormality can be corrected with filler injections, 2) remove the implant, reshape it, and reinsert it and 3) remove the implant and replace it with another type of implant.
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Crooked Nose after Rib Graft

If your surgeon and all surgeons who have seen you agree that the rib graft is crooked, you have 2 choices; either reposition the graft or depending on the width of the graft, place fillers.
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Crooked graft after rhinoplasty

A crooked graft usually has to be removed and replaced or repositioned. You can camouflage it sometimes with fille material.
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Revision Rhinoplasty

If the rib graft is crocked, then you will need another surgery. If the rib graft is salvegable, by removing it and burring it to be straight, that is good, otherwise you may need another graft, Rib cartillage or synthetic (Rib cartilage is more biologic)
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Sometimes a crooked graft on your nasal bridge can look better after an Injectable Filler procedure.

I read your concern. You may want to re-post your question with a photo for the RealSelf community of experts to comment on: I have personally placed an ePTFE graft for dorsal nasal augmentation that ended up looking a bit crooked after swelling resolved. In my patient, the asymmetry was most prominent at the top of the bridge at the radix. Rather than removing the graft, I used an injectable filler to restore symmetry. This could make your nose look wider, so without a photo, I could... more

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