I had reconstructive rhinoplasty and an onlay rib graft was placed on my nose. The edges of the graft are very sharp and protrude through the skin, making it very easy to discern to graft under certain kinds of lighting. This is intolerable as my nose looks very unnatural. Can anything be done about this? Are there techniques to soften the edges of such a graft?
Rib Graft Protrusion?
Doctor Answers (5)
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Revision rhinoplasty for rib grafting
When a rib graft has been placed in patients with thin skin, the edges can show through. There are 2 options that are available which would include removing the implant shaving it and softening the edges or potentially wrapping it in some type of fascia layer or inserting a piece of fascia over the top of the graft. fascia can be harvested from behind the ear or from the scalp.
Rib Graft Protrusion?
If the rib graft is breaking through the skin, you should go back and see the plastic and cosmetic surgeon that did your Rhinoplasty. If the edges are visible, they can be shaved down but this would require incisions inside the nose in order to gain access to the rib graft.
Softening visible edges of onlay rib graft
If only a small edge is visible, sometimes it can be softened by shaving it in the office with a needle under local anesthesia. If it is a large visble area, then a small revision may be necessary to revise the graft either my softening its edges or camouflaging it with an additional graft of temporalis fascia or acellular dermis.
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Rib graft protrusion
Yes the graft can be removed, smoothed and contoured and replaced. In some patients who have thin skin or skin that tends to contract around the graft and show it's edges it can be helpful to cover the graft with a layer of temporalis fascia or alloderm. This supports the skin while it is healing and soften the tendency to show sharp edges.
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