How difficult is removal or reduction of DCF nose graft one year post op?

Question

How difficult is complete removal or reduction of DCF after a year due to improper positioning/3mm shifting directly after OP? Dorsal graft height 7-9mm (excessive height + too narrow b/w radix) curve on side, graft protrusion palpable superior right lateral aspect b/w eyes w/ indent +sharp superficial tissue. Inferior left lat soft tissue lump palpable since post op. (nose looks like a 'forward slash'). Surgeon unwilling to revise. Suggestions appreciated. post op = Petite w/ masculin nose.

Jeremy Hunt, MBBS, FRACS · Answer

The diced cartilage graft is designed to incorporate into your tissue and this is what would make removal somewhat difficult though not impossible.The real question is going to be what to do once the cartilage is removed. You have an extensive list of concerns and any revision rhinoplasty especially with removal of the graft, may address some of your issues but possibly not all.You need a consultation with an experienced surgeon with a special interest in rhinoplasty, from there you can assess what may be possible from a revision rhinoplasty and plan the best way forward.I hope that helps and all the bestJeremy Hunt

Kenneth Hughes, MD · Answer

The graft can be removed or reduced without much difficulty.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

Donald B. Yoo, MD, FACS · Answer

For a surgeon experienced with diced cartilage fascia grafts, complete removal is fairly straightforward.  Adjusting the size, shape or height of the graft requires some additional manipulation and may or may not require additional harvesting of graft material depending on the condition of the DCF.

Darryl J. Hodgkinson, MD, FACS, FRCSC (retired) · Answer

This could be difficult after 1 year.
Perhaps you have had more than one rhinoplasty and these have been open ?
Best option might be to seek a second opinion from a very experiencd surgeon who has dealt with a lot of secondary cases.

Richard W. Fleming, MD (retired) · Answer

The graft can be removed, the size or shape changed, and then replaced. Try talking to your surgeon one more time before consulting with a revision rhinoplasty specialist.

How difficult is removal or reduction of DCF nose graft one year post op?

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