Your middle third is also narrow, setting you up for postoperative internal valvular incompetence.' What does that mean for my breathing? I would be getting a fascia graft, but would that help hide the point my nose now has? Give it more slope from the bridge? I'm not looking for a miracle. My profile is miserable, but now the front is just as bad. Repercussions for my nose type?
Fascia Grafts for Thin Skin First Rhinoplasty? (photo)
Doctor Answers (9)
Fascia grafts for thin skin during rhinoplasty
Your questions are pretty technical, though yes, a fascia graft is used though seldom so to hide irregularity on the bridge when the skin is thin. This works particularly well for a revision where grafts are used to raise the dorsum to hide imperfections. Spreader grafts are very commonly used when the internal valve is narrow, or when the nasal bone broadens and a 'V' might appear as the bridge is reduced. You should expect an excellent result so avoid technical jargon and look for a surgeon who can demonstrate to you a plan for the look you feel is right for you. With skill, much is possible with rhinoplasty.
Rhinoplasty with middle third depressions.
Rhinoplasty with middle third depressions. For 35 years I have used both cartilage and combined this with fascia for thin skin noses.
Using spreader grafts for collapse of the internal nasal valve
If the middle third of your nose collapses on inspiration this means that you have some degree of incompetence of the internal nasal valve. The usual treatment is to build up the width of the middle third by using spreader grafts.
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Nose Internal Valvular Incompetence
Ir seems that your surgeon was trying to say that the nose "internal valve" (an area beyond the nostrils and inside your nose) is narrow and may increase your risk of breathing problems. One solution is to place cartilage "spreader grafts" in the valve to open it up and improve air flow.These grafts may improve the appearance of your nose also.
Fascia grafts or spreaders?
I think this is a fascia graft would be one is in your case. Additionally, however I think the middle third of your nose would benefit from what are called "spreader grafts". These are commonly done for a few reasons.
It helps the middle third of your nose not look so narrow and hourglass-likeand overall reduces the prominent appearance of the nasal bones
additionally, it would help with the internal valve issue and breathing that you most likely have.
This would give your nose a somewhat uniform width from the area between your eyes all the way down to your tip but I think that that would probably be a pleasing improvement.
Get several consultations and ask your rhinoplasty surgeon about these things.
Chase Lay, MD
Fascial Grafts in Rhinoplasty
Fascial grafts are a very good method to help disguise potential irregularities of the middle vault of the nose from rhinoplasty changes. You are certainly a great candidate for their use as your nasal skin is thin and you already have a middle third depression.
Fascia grafts in rhinoplasty
I am aware of using facial grafts to help contour the nasal bridge, but have never found it necessary to use them. You can get a nice result without getting overly complicated with the procedure. Concentrate on finding an experienced rhinoplasty surgeon, one whose results you like. Personally, when it comes to rhinoplasty, I prefer to keep things simple and straightforward. That's the way to get good consistent results. Good luck!
Fascia grafts and spreader grafts for rhinoplasty
Fascia grafts are placed on top of the bridge line to soften a cartilage graft when a patient has very thin skin. This is usually used across the nasal dorsum. When the mid third of the nose pinched, or collapsed, then cartilaginous spreader grafts are placed underneath the upper lateral cartilages to give more with structure and support to this area. Fascia grafts are usually not required when spreader grafts are placed, since they are underneath the skin and underneath the upper lateral cartilage.