I just found out today from an ENT doctor that I have a slight to moderate deviated septum. I am looking into having a revision rhinoplasty because my primary rhinoplasty (2 years ago)caused a scooped out bridge and what looks like the side walls to collapse. Will I now need to have grafts taken from my rib and ear? Should I have the deviatd septum work done by a revision specialist since I have already had one rhinolpalsty? Can I have all this work done at the same time?
Can Your Septum Be Used for Grafting for a Revision if Its Slightly Deviated?
Doctor Answers (11)
Using Septal Cartilage For Revision Rhinoplasty
For grafts, septal cartilage would be ideal, followed by rib. A revision rhinoplasty specialist would be the best surgeon to contact. All the work should be performed at the same time, as it would not be necessary to split it up into two surgeries. In addition, you would have the septal cartilage on hand if necessary. Thank you, and I hope this helps.
Septum can be used for a revision
Depending on the extent of your external deformity, septal cartilage could be sufficient to resolve your contour irregularity. Deviated septal cartilage can be straightened during surgery and used as a graft - you should not worry about this. Rib cartilage would only be necessary if your deformity is significant. Most patients have sufficient septal and ear cartilage, as well as fascia, to augment most nasal depressions.
You should do your surgery (rhinoplasty and septoplasty) at once and seek a rhinoplasty specialist with experience, given that this is a revision situation. Good luck,
Grigoriy Mashkevich, MD. New York Facial Plastic Surgeon.
If you had no previous septal surgery then all the better as in correcting it during this procedure it may serve as a source for grafting if necessary. Ear and rib cartilage is only necessary in the patient with depleted nasal cartilage.
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Video: Revision Rhinoplasty and using deviated septum
It depends if you have any usable septum left. Usually after a rhinoplasty septal cartilage is the first to go. With the deviation you may need some work to the existing septum that could require more cartilage and the need for more. This would entail using ear cartilage. This is something for you and your surgeon to consider. I always have as a back up the need and the consent to use ear cartilage if needed. The septum needs at least 1 cm of bridge and nostril area left to hold and support the nose. It is the part of the foundation of the septum that is needed for support.
Don't like rib grafts for Revision Rhinoplasty
I have performed Rhinoplasty and revision Rhinoplasty for over 20 years and I do not use rib cartilage or bone to build up the nasal bridge because it has a habit of dissolving unevenly years after the Rhinoplasty. You can do a google search and find scientific papers on this subject.
The septum cartilage can be used, more difficult if it's crooked as this will not yield a straight cartilage segment to lay on the nasal bridge. I have to say that in my experience, the cartilage septum is rarely long enough to build up the entire length of the nasl bridge which goes from the Radix to the supratip area. The availble septal cartilage is typically a bit short and for that reason, I use a straight silastic dorsal nasal implant to reliably build up the nasal bridge.
Ear cartilage is curved and when fiolded and used, to build up the nasal bridge, also has a history of dissolving unevenly...again a google search of dissolved ear cartialge for dorsal augmentation would shed further light on this issue.
Depending upon how much height you need on your dorsum will certainly affect the choice of grafts. If you need a lot of graft material, then a rib may be best. If you have a deviated septum, the septum can also be used for graft material.
Cartilage Grafting in Revision Rhinoplasty
Yes, you can and should have both functional and cosmetic issues regarding your nose addressed at the same time. Those procedures would include septoplasty (possible turbinate reduction) combined with a revision rhinoplasty. Yes, septal cartilage can be used for grafting purposes if still present. If you require only augmentation of your dorsum (bridge), it is in consequential if the cartilage is bent as I prefer to use a graft made of diced cartilage wrapped in fascia for this type of problem. I feel it provides a much more natural correction. If further grafts are necessary to correct nasal valve collapse, ear or rib cartilage can be utilized. I suggest you seek a surgeon skilled in revision rhinoplasty to correct your functional and cosmetic issues. Good Luck, Dr. Corrado
Nasal cartilage from your deviated nasal septum may be used for reconstruction during Revision Rhinoplasty Surgery.
I read your concern. If your septum has not been operated on during your first nose job, this repository of cartilage may be helpful for your revision rhinoplasty surgeon. Your surgeon may be able to tell if you have septal cartilage remaining by gently pushing it with a Q-Tip.
It would be beneficial to have your deviated septum addressed at the time of your revision rhinioplasty. You may not need to have ear or rib cartilage harvested.
I hope this is helpful for you.
Regards from NJ.
One should be able to use the septum.
If there is enough cartelage in the septum - deviated or not, we should be able to use it to build up your dorsum. You just need the right doctor with experience in doing both the inside and outside of a nose.
Having deviated septum fixed during revision rhinoplasty
You can have the septal deviation fixed during your revision rhinoplasty. In fact, the septal cartilage will most likely be needed during the rhinoplasty surgery. In some cases even more cartilage is needed an ear or rib cartilage would need to used as well.
Find a revision rhinoplasty surgeon well versed in septoplasty and rhinoplasty surgery who can take care of both issues at the same time.