Can a septal implant be removed safely without damaging the mucosa?

Question

Three years ago I underwent the following procedure to increase air resistance on the right side of the nose: "Right-sided hemitransfixion incision. Elevation of the mucoperichondrium, only on the right side. A couple of cartilage grafts were inserted at the anterior portion of the septum. Closure of the hemitransfixion incision." Unfortunately, since the surgery I have been experiencing persistent pain in an area of the right septum. In that same spot, the mucosa appears thinner and at times I can even see part of the implant underneath. For this reason, I would like to consider removal of the cartilage grafts. I would appreciate your opinion on the following: 1) Is this a difficult operation? 2) Could removal of the grafts further damage the nasal mucosa? 3) Is there a risk that removal could create scarring? 4) Is there a risk that removal might worsen nasal dryness? 5) Is it likely that the grafts have adhered to the septum making removal more complicated? Thank you very much for your time and advice.

Alejandro Nogueira, MD · Answer

Yes, it can be removed; from your description I believe that septal grafting is too thick and a source of issues for you; removing it may reverse the structural problem it was addressing, so maybe it is wiser to thin it down or apply a beter suited type of grafting.

More technical detail and images are needed for a better understanding and advice.

More technical detail and images are needed for a better understanding and advice.

Eric M. Joseph, MD · Answer

Generally, it is not typical to perform nasal surgery to increase resistance of air flow. Most people have a problem with nasal obstruction and need relief. I believe the answer to this question would need to be addressed by the surgeon you are working with. If this is not feasible, you may benefit from a second opinion from another reputable nasal surgeon near you. I hope this helps. Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your description, these grafts could likely be removed during a revision but new grafts should likely be placed. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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

Best wishes and good luck.

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

Can a septal implant be removed safely without damaging the mucosa?

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