Rib tissue was mine, but I got infection. My Dr removed implants supporting valves. Without implants, and with scar tissue pushing into nose, breathing is restricted. Lying on my side, it feels "weight" in my nose flips with me, and blocks air even more. Dr recommends ear graft. How soon is ok? Will this solve the breathing issue due to scar tissue pushing in? If not, can tissue be shaved? I rather not try cort. injection again, as I think it damaged some soft tissue while ignoring tougher bits
Septoplasty and Nasal Vestibular Stenosis Repair with Rib Graft Complication?
Doctor Answers (7)
Nasal valve problems in Revision Rhinoplasty
These are difficult problems and there is no one right answer. Fortunately, there are many options. First, it is important to remember that scar tissue will continue to remodel for the first 18 months. So likely much of the "weight" will improve. Patience is indicated (and wise) in this situation to avoid a surgery that you may not need.
However, if you do need surgery, ear cartilage is a good option. Using cartilage as an "alar batten" graft will likely solve your problem, but placement can be tricky. Make sure your surgeon has a great deal of experience in revision rhinoplasty and again, waiting at least 6-8 months from your last surgery is prudent.
Septoplasty and Nasal Vestibular Stenosis Repair?
Boy this is a very tough situation. You did not give us any timing of when your surgeries were. That makes a big difference. Scar tissue can take up to 12 months to resolve. It is very hard for me to give you really good advice without examining your nose. I do these surgeries all the time. It sounds like you have collapse of the valves of your nose from the prior surgery that you had. If you were diagnosed correctly from the beginning the you will likely need cartilage grafting again at some point. I would let things settle for at least 8 months to a year. It makes nose revision surgery so much better. Working in a nose with dense scar is tough. Find a board certified surgeon that specializes in these types of procedures as well. Revision nasal surgery is VERY DIFFICULT!
Complication Following Rib Graft for Vestibular Stenosis
Without knowing when you had your last surgery and subsequent post -op complication it is impossible to recommend when you should consider another revision. However, ear cartilage is a good choice and easier to harvest than the ribs.
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Nasal valve issues and collapse
Once things heal, you may be able to undergo another rhinoplasty attempt but I would probably consider rib graft again. It is sually a much more durable graft material than ear cartilage.
Rib graft complications.
You need to see an experienced revision rhinoplasty surgeon. I usually recarve the rib you have and do not have to go to the ear. I need to see photos.
Treating nasal valve collapse
It's hard to say what the best timing and course of action would be in your case without seeing your nose. It may be necessary to also remove some scar tissue if it is thick and impeding your air flow. Ear cartilage isn't as strong as rib cartilage, but ear cartilage can be useful depending on the area that needs to be treated.
You can check out my link below to learn more about repairing nasal valve collapse
Septoplasty and Nasal Vestibular Stenosis Repair with Rib Graft
It is very difficult to answer your question without seeing you in person and examining your nose – you may be able to attempt another surgery with rib graft which is a better choice than ear cartilage for nasal valve problems since it is much stronger