Success of mid-vault collapse repair on both sides?

Question

I know success heavily weighs on a surgeon's skills and techniques.... but talking about the average success of using ear or even rib for mid-vault collapse on both sides, what are the chances of graft re-absorption and additional surgeries? I'd like this next (my second) to be my LAST. Yet I hear from patients who consult with regular ENTs that these types of corrective surgeries *always* fail.... which alarms and depresses me. Any long-term success rates documented?

Kenneth Hughes, MD · Answer

Spreader grafts can be placed without much difficulty through a closed or open approach.  They are effective, and they remain effective.Find a plastic surgeon with ELITE credentials who performs hundreds  
of rhinoplasties and rhinoplasty revisions each year.  Then look at the 
 plastic surgeon's website before and after photo galleries to get a   
sense of who can deliver the results. 	Kenneth Hughes, MD Los Angeles, CA

Jonathan Kulbersh, MD · Answer

When the middle vault collapses, it causes both aesthetic and functional concerns (nasal obstruction).  The middle vault is repaired using strong and straight cartilage grafts.  This best cartilage for this repair is septal or rib cartilage from your own body.  Both of these cartilages have been used in the successfully in the nose for years without concerns of re-absorption.  Sometime rib cartilage from other sources, not your own body, is used for nasal reconstruction.  This cartilage has a chance to re-absorb.  I would discuss this with your doctor.I hope this helps.

Kian Karimi, MD, FACS · Answer

Using ear or rib cartilage for reconstruction of the mid-vault (typically in the form of spreader grafts) is highly successful with very little chance of graft re-absorption. When placed correctly, these grafts are highly successful to treat both cosmetic and functional issues of the nose.  When performed correctly, these have been documented to be successful at 20 years and longer.

Roy A. David, MD · Answer

The middle vault of the nose is composed of the septum and the upper lateral cartilages. Sometimes after rhinoplasty this area is left weakened and may move inward with inspiration. This is also known as internal nasal valve collapse. Fixing this is relatively straightforward in most cases. Septum and ear cartilage are commonly used, autologous rib cartilage in extreme cases, and loss of the grafts would be highly unlikely.  Consult with a surgeon who is a rhinoplasty specialist and can demonstrate excellent results-as well as correctly diagnose your issue.

William Portuese, MD · Answer

Spreader grafts were harvested from nasal, ear, or rib cartilage. Once inserted into a small pocket underneath the upper lateral cartilage the rarely ever resorb. They have an excellent success and take rate and had been used for many years with minimal complications in experienced hands. For many examples, please see the link below to our rhinoplasty photo gallery

Richard W. Fleming, MD (retired) · Answer

Cartilage harvested from your septum, ear, or ribs s used to reconstruct the mid  vault. This procedure is very successful. As far as I know, in over 30 years I've never had this cartilage absorb.

Success of mid-vault collapse repair on both sides?

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