Are there alternatives to grafting for collapsed cartilage indent on nose?

I am very frightened by grafting, having read the dangers of migration, warping, chances of visibility as skin thins, and the increased risk of septal perforation or changes of decreased scent when messing with the septum. Are there alternatives for fixing collapsed cartilage or an indent in the nosal bridge from a break other than fillers? Can the dr just rebreak the nose and move the cartilage back as he would do with the bone during osteotomies?

Doctor Answers 5

Alternatives are collapsed cartilage in the nose

In our practice, we do not recommend fillers placed in the nose due to the complications that can occur from their placement in addition to the fact that there are only temporary. Treatment for the crooked nose involves osteotomies and breaking the nasal bones back to their normal position to make them straight.  The gold standard for fixing a collapsed upper lateral cartilage is placement of a spreader draft. The spreader graft is placed underneath the existing concave upper lateral cartilage in the midportion of the nose in a very precise pocket, so it does not migrate, warp, or is visible. It's very rare to get a septal perforation. It's also extremely rare to get decreased sense of smell after a small cartilage harvest.  For more information and many examples, please see the video and the link below 


Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Alternatives to Cartilage Grafts for Collapse Nasal Cartilages

You do reference many complications associated with cartilage grafts but in the hands of experienced rhinoplasty surgeons they do not occur very often. Fillers provide temporary cosmetic improvements but they will not reduce any associated breathing obstruction. It is possible to rebrake the bones but without pictures I don't know if this will achieve your goals 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Grafting

Cartilage grafting is generally very safe in the nose.  However, for the nasal bridge, it may be that recontouring the septal and upper lateral cartilages would suffice in correcting contour irregularities in this area.  

Grafts

Hello and thank you for your question. The best advice you can receive on this particular question would be from an in-person consultation.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 79 reviews

Fixing irregularities

Small irregularities can be fixed with fillers. Although it is not permanent the HA fillers can last 1-2 years. Surgery can be done easily but of course involves additional surgery, although it is usually minor. More definitive surgery is sometimes possible but always carries additional risk of failure. It really depends on the appearance, location and size of the irregularity. A good rhinoplasty surgeon should be able to go over all your options. Good luck.

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.