Can cartilage grafts be trimmed back or removed in Revision Rhinoplasty?

Question

I have seen numerous mixed responses from doctors on this site relating to the question on whether cartilage grafts placed from prior rhinoplasty can be removed. Some surgeons respond yes and that graft removal is quite easy whereas others indicate that it cannot be done as it will adversely impact breathing and/or lead to poor aesthetic results. What is the true answer for grafts harvested from septum in primary rhinoplasty and placed adjacent to nasal bone causing wider more unattractive nose?

Andrew Miller, MD · Answer

Cartilage grafts that are simple onlay grafts can easily be removed during revision rhinoplasty. A graft that has been placed as an integral structure of the nose during the first surgery can be much more difficult to deal with. Be sure to see a surgeon that specializes in revision rhinoplasty for consultation, but if the cartilage is just sitting next to a nasal bone, it can usually be removed.

Tanveer Janjua, MD · Answer

Cartilage grafts usually survive a 100% and are not absorbed by the body. In that case they can be removed. However, if the body has absorbed the grafts then it becomes part of the scar tissue and cannot be removed. It is hard to determine this till you open the nose. RegardsDr J

Giancarlo Zuliani, MD · Answer

Hello and thanks for the question. All grafts can be removed during rhinoplasty and if these grafts have warped or moved, they should be removed and repositioned. This occurs during nearly every revision I perform. Not all grafts are structural or functional. Some are meant as camouflage and are meant to improve cosmesis. Structural grafts in rhinoplasty are akin to the framework of your house. You need certain sturdy beams and buttresses to keep the nose in the correct position and to provide strength in the areas which tend to collapse and cause functional disturbance after surgery. All in all, make sure you understand what needs to be done and make sure your doctor has performed enough revisions to know what problems can arise and how to correct these issues at the time of revision.

Michelle R. Yagoda, MD · Answer

Dear Pepper123,Technically, cartilage grafts can be removed.  But, they may be necessary for normal nasal function.  Removal of grafts may lead to nasal airway obstruction.  Replacement grafts may be placed that are sized and shaped differently, but a graft may ultimately be necessary for functionality of the nose.  Photos would be helpful!All the best,Dr. Michelle Yagoda

William Portuese, MD · Answer

Cartilage grafts can be removed at the time of secondary rhinoplasty, but there has to be a very good reason to remove them. Scar tissue and the contraction process can alter the healing process after the removal. Spreader grafts are not easy to remove, and may cause more damage during the removal process and can cause the upper lateral cartilages will collapse inward again.

Can cartilage grafts be trimmed back or removed in Revision Rhinoplasty?

Answers (10)