Donor Rib Cartilage on Bridge Skin Is Red- Should I Worry?

Cadaver cartilage grafts are more likely to cause an inflammatory reaction than are a patient's own cartilage grafts. As long as the graft is not overtly infected, it is probably best to wait about a year prior to undergoing nasal revision surgery. However, your surgeon may need to take this graft out sooner if there is a clear cut infection. Your best bet will be replacement with a graft made out of your own cartilage, either from your ear or rib. Placing deep temporal fascia along the bridge will also help to mask any visibility and may also be considered.

When you have these concerns at any time after any type of implant/cartilage is used for dorsal nasal augmentation, it is a cause for considerable concern. Whether it is an impeding infection, or more likely a pressure phenomenon from the graft, it should be evaluated and addressed promptly. Time is not on your side when it comes to a satisfactory solution when it comes to this type of rhinoplasty problem.

With your complaints about redness and visiblity, it is concerning.  Photos and better yet a physical exam in person is ideal.  It sounds like it could be impending extrusion of  the rib. 

Without a photo is is difficult to tell you any specifics, but what you are describing should be evaluated by your doctor. You want to ensure that there aren't any problems or risk of exposure of the graft. The donor rib can be reabsorbed with time and you may have a chronic inflammatory response related to this absorption of the donor. Waiting for a full year is normally recommended so that your surgeon can make an accurate assessment of your final results.  You will also likely need to have additional cartilage replaced in this area, so consult with someone experienced in revision rhinoplasty.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

it is difficult to be sure without an evaluation. but I would recommend you see your surgeon promptly and have them check things out.

You do need to be concerned, but you don't have enough information.  See your doctor.

The most important thing to worry about is an infection, especially in light of the red skin.  This may or may not be an issue.

Second thing is the possibility of a malpositioned/visible graft.  If no infection, you will need to wait before a secondary procedure in order for the tissues to become optimal, and for swelling to subside enough to really see what the final result will look like.

sek

Hi,

At 2 months postop it's possible that you have an infection but it sounds like the graft might be putting too much tension on the skin and causing inflammation. If this is the case, then the implant should be removed. Either way it sounds like you want the implant removed. See what your surgeon has to say about it.

Best,

Dr.S.

 

 IMHO, you should be seen and evaluated by the Rhinoplasty Surgeon that did your Rhinoplasty to rule out an infection or pending skin extrusion.  

Red, thin skin over a rib cartilage graft on your bridge should be evaluated by your surgeon ASAP because you don't want to deal with a graft extrusion. Placement of a fascia graft to protect the skin and repositioning of the graft should be considered in the near future. Removal of the graft is a choice but that may not be necessary.