Any suggestions on onlay peck graft?

I was informed most grafts are placed in a precise pocket and scar tissue forms and you are set for life so I am content with that. I read my notes and saw that one of my grafts, the onlay peck graft, was sutured to the domes with nylon sutures. I am very worried. What if over the years my nylon sutures come loose or fail,l will the tip graft just come loose and become mobile, or does it form scar tissue ( I think not because its on the tip) and the underlying structure keeps it tight? oppinions

Doctor Answers 6

Cartilage grafts

In the absence of significant trauma, it would be unusual for any nasal cartilage grafts to come loose. Most nasal cartilage grafts are sewn in place. I typically use PDS suture...which is absorbable. However, it takes about 3-4 months for the suture to absorb...just long enough for your body to grow scar tissue that will keep the graft in place.

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 22 reviews

Nasal cartilage graft

It sound like you are pleased with the result currently.  If the graft becomes a problem it can always be removed, but it sounds like it's doing fine.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

Nasal Tip Grafts

Nasal cartilage graft are placed for a purpose, most often cosmetic but frequently to augment structural support. Sutures hold them in place until the soft tissues (normal scarring) is sufficient. They can be removed surgically but the indications are rare. If the correction is good now, it will be good for many many decades, even though the cartilage can warp, on occasion.

Larry C. Leverett, MD, FACS
Phoenix Plastic Surgeon
4.7 out of 5 stars 17 reviews

Sutured Grafts

You are confused.  Sutured grafts are more secure and less apt to be misaligned then onlay/Peck grafts. That's why most surgeons like to suture grafts. 
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Nasal tip grafts

Nasal tip grafts typically sutured to the underlying nasal cartilage to keep them in place until scar tissues are formed. Permanent sutures are also used. Essentially, once healing is complete, graft should stay were they are placed but forces of scar contracture can displace them even when sutured in place. Nature sometimes has its own rules. Best

Mohsen Tavoussi, MD, DO
Orange County Facial Plastic Surgeon
4.6 out of 5 stars 12 reviews

Graft security

Don't know what peck grafts are, but you should remember that grafts integrate and are non-mobile after one month; sutures are not present when we go back for a revision rhinoplasty and the grafts are secure.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 65 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.