Hello surgeons! I'm six months post primary rhinoplasty. After getting access to my operative report, I'm very concerned about the grafts. They are as follows: spreader grafts: (2) 1mm width X 1.5 cm X 4 mm height septal cartilage in right nasal tip: 4mm X 4 mm columellar strut: 1.2 cm length X 4mm in width alar rim grafts: (2) 1 cm length X 2.5 mm width X 1 mm thick I do have an upcoming appointment for a revision from a different surgeon. I just can't believe it. :-( Thank you!
February 22, 2019
Answer: Are these grafts too big/too many? We use CStruts and spreader grafts regularly, when necessary, and these may not be causing your concerns about your nose. When you consult with another rhinoplasty specialist, your operative report and preoperative photos may be helpful for determining what might be best for you moving forward. Wishing you well. Dr Joseph
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February 22, 2019
Answer: Are these grafts too big/too many? We use CStruts and spreader grafts regularly, when necessary, and these may not be causing your concerns about your nose. When you consult with another rhinoplasty specialist, your operative report and preoperative photos may be helpful for determining what might be best for you moving forward. Wishing you well. Dr Joseph
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February 24, 2019
Answer: Hmm. Grafts are only too big/too many if they make your nose look wrong... I'd concentrate on what you don't like about your nose, whether or not the problems were generated from grafts. There are a lot of people with big problems after primary rhinoplasty who had *no* grafts, but they still need a skillful revision. The revision surgeon won't just be removing the grafts. He'll be trying to change your nose to its original goal, whether that's by removing/modifying the grafts, or changing your natural cartilages and bone. As you unfortunately know, rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. Any revision requires advanced techniques, requiring skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon, and how to tell whether your first surgeon should be performing your revision. Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! But remember, you're not the surgeon for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
Helpful 1 person found this helpful
February 24, 2019
Answer: Hmm. Grafts are only too big/too many if they make your nose look wrong... I'd concentrate on what you don't like about your nose, whether or not the problems were generated from grafts. There are a lot of people with big problems after primary rhinoplasty who had *no* grafts, but they still need a skillful revision. The revision surgeon won't just be removing the grafts. He'll be trying to change your nose to its original goal, whether that's by removing/modifying the grafts, or changing your natural cartilages and bone. As you unfortunately know, rhinoplasty is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. Any revision requires advanced techniques, requiring skill that most plastic surgeons don't possess with expertise. For most noses, it's much better to not have surgery than to have inexpertly-performed surgery. Read my essay on how to stay out of trouble while selecting a rhinoplasty surgeon, and how to tell whether your first surgeon should be performing your revision. Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish -- what features he thinks he can change, and by how much he thinks he can change them. I always email morphs to my online rhinoplasty consultations. When you see the surgeon's goals in the morphs, you'll know whether he has an eye for an attractive nose, and whether he shares your opinion of what constitutes an attractive nose. You'll also know whether the changes he proposes are large enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. How would you ever get that figured out without the morphs?! But remember, you're not the surgeon for his skills with the computer. The doctor must then show you his before and after photos to prove that he can actually accomplish what he draws on the computer.
Helpful 1 person found this helpful