I understand that revision rhinoplasty is inherently complex however I know that some techniques are more difficult than others. I had a revision several months ago and I am happy with the overall shape and dimensions however I believe I have a midvault collapse at least on one side. I am thinking that I will need spreader grafts placed and may possibly need a larger graft on one side than the other. Is this fairly straightforward and can I expect long-lasting results?
In the Context of Rhinoplasty, How Difficult is It to Fix a Midvault Collapse?
Doctor Answers (3)
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rhinoplasty for mid vault collapse
The best way to repair a unilateral mid vault collapse is by placing a spreader graft underneath the upper lateral cartilage on the concave side. If both sides are collapsed then bilateral spreader grafts will need to be inserted. The hardest part of this procedure is figuring out where to obtain the cartilage from, since there's been previous nasal surgeries and a possible cartilage depleted nose. If that's the case, then ear cartilage will need to be harvested to fashion a spreader graft.
Spreader Grafts in Revision Rhinoplasty
Thanks for the question. Correction of middle vault collapse can be accomplished with spreader graft placement on one or both sides. The cartilage is ideally taken from your septum, but in cases where septal cartilage is insufficient, ear or rib cartilage may be needed. The results are durable, as the risk of resorption of the cartilage grafts is very low. I typically stitch them in place with permanent sutures. I would recommend that you seek one or more consultations with experienced revision rhinoplasty specialists, for whom this technique should be pretty straightforward. Lastly, if you are having difficulty breathing, widening the internal valves of the nose with spreader grafts (vestibular stenosis repair) may be covered by your insurance.
Correction of Nasal Midvault Collapse
If there is a cosmetic problem or breathing obstruction spreader grafts can be fashioned to improve either or both. Make sure that you wait 9-12 months after your revision, which takes longer to heal. You will do fine as long as you choose an experienced surgeon.