How is this fixable? 7 months post op (Photos)

Hi I am 7 months post op from primary rhinoplasty. Dr said that my bone went in too much. He has suggested using gore-Tex to fill in the area but I've heard it has a high rate of complications. If I were to have a revision, can the bone area be filled back up with cartilage?

Doctor Answers 6

Nasal contour irregularity

This is mid-vault collapse.  This needs to be treated with a cartilage graft from you.  This should be straight-foward to fix.  NO GORETEX!

Nasal contour irregularity

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This is mid-vault collapse.  This needs to be treated with a cartilage graft from you.  This should be straight-foward to fix.  NO GORETEX!

Keystone area

your collapse is at the so called 'keystone' area where the nasal bones meet the dorsal cartilaginous septum.... when this area is over-resected, upper lateral cartilages lose support and/or infracture of nasal bones doesn't go as perfectly as intended, there are classic functional and aesthetic consequences.... i am of the mindset that these are best address anatomically with structural cartilage grafting rather than fillers or man-made substitutes


good luck....

Keystone area

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your collapse is at the so called 'keystone' area where the nasal bones meet the dorsal cartilaginous septum.... when this area is over-resected, upper lateral cartilages lose support and/or infracture of nasal bones doesn't go as perfectly as intended, there are classic functional and aesthetic consequences.... i am of the mindset that these are best address anatomically with structural cartilage grafting rather than fillers or man-made substitutes


good luck....

Contour deformity after rhinoplaty - How is this fixable? 7 months post op

Hello cdp1 - Thanks for your question. An easy way to fix the contour irregularity would be to use injectible filler. The procedure is done in the office using topical anesthesia. It can completely correct the issue, but it has to be performed every year. The more permanent solution would be revision rhinoplasty to place a right sided spreader graft to fill in the defect and straighten the bridge while elevating the upper lateral cartilage on that same side. Make sure your surgeon feels comfortable with this plan, or get a second opinion from a specialist in revision rhinoplasty. 

Good luck, 

Dr. Shah

Contour deformity after rhinoplaty - How is this fixable? 7 months post op

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Hello cdp1 - Thanks for your question. An easy way to fix the contour irregularity would be to use injectible filler. The procedure is done in the office using topical anesthesia. It can completely correct the issue, but it has to be performed every year. The more permanent solution would be revision rhinoplasty to place a right sided spreader graft to fill in the defect and straighten the bridge while elevating the upper lateral cartilage on that same side. Make sure your surgeon feels comfortable with this plan, or get a second opinion from a specialist in revision rhinoplasty. 

Good luck, 

Dr. Shah

Nasal Depressions 7 Months Post Rhinoplasty

Yes, depressions can be augmented after rhinoplasty surgery. However I use the patient's own tissue, in this case cartilage, rather than synthetics such as Gortex which are easier to place but have a much higher complication rate.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Nasal Depressions 7 Months Post Rhinoplasty

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Yes, depressions can be augmented after rhinoplasty surgery. However I use the patient's own tissue, in this case cartilage, rather than synthetics such as Gortex which are easier to place but have a much higher complication rate.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

How is this fixable? Seven months postop rhinoplasty

From the limited photographs, it appears that the nasal  bones themselves are straight, however the upper lateral cartilage in the midportion of the nose is concave. This can be fixed with a unilateral spreader graft harvested from inside the nose placed underneath that concave area. We do not recommend Gore-Tex placement in the nose due to significant complications we have seen from it over the last 25 years. For more information about spreader grafts and many before-and-after examples, please see the link and the video below

How is this fixable? Seven months postop rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

From the limited photographs, it appears that the nasal  bones themselves are straight, however the upper lateral cartilage in the midportion of the nose is concave. This can be fixed with a unilateral spreader graft harvested from inside the nose placed underneath that concave area. We do not recommend Gore-Tex placement in the nose due to significant complications we have seen from it over the last 25 years. For more information about spreader grafts and many before-and-after examples, please see the link and the video below

Postrhinoplasty Contour Irregularities

Thanks for your question.  What you have experienced can be common for many patients.  However, the degree to which there is a contour irregularity varies greatly.  Thus, the treatment will as well.   In general, filling this area with a material that is soft can do a lot for volume.  Gore-Tex is definitely an option and actually, when performed under strict sterile techniques, can be a nice adjunct for post-rhinoplasty contours.  There are also other options like morselized cartilage or fascia as well.  In addition, some surgeons may offer placement of an injectable filler in the clinic to treat the area for up to one year without surgery.  All of these are options and are at the discretion and experience of your surgeon.  Talk further with your surgeon to see what options are best for you in their hands.


Best wishes.

Postrhinoplasty Contour Irregularities

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Thanks for your question.  What you have experienced can be common for many patients.  However, the degree to which there is a contour irregularity varies greatly.  Thus, the treatment will as well.   In general, filling this area with a material that is soft can do a lot for volume.  Gore-Tex is definitely an option and actually, when performed under strict sterile techniques, can be a nice adjunct for post-rhinoplasty contours.  There are also other options like morselized cartilage or fascia as well.  In addition, some surgeons may offer placement of an injectable filler in the clinic to treat the area for up to one year without surgery.  All of these are options and are at the discretion and experience of your surgeon.  Talk further with your surgeon to see what options are best for you in their hands.


Best wishes.

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.