Is Graft Removal Hard and Can it be Done with Local Anesthesia??

my grafts from rib grafts were sutured in my nose... would it be "Easy" or hard to remove it? could it be gone local anesthesia? can it be done opened or closeD?

Doctor Answers 6

Is graft removal hard?

If you are still working with your original surgeon he/she is in the best position to answer this for you. Your original surgeon has the best knowledge of what was done and what the surgical obstacles are that are likely to be encountered. When I approach a revision on a nose that was operated on by someone else I am always thinking about what I may need to do if what I find is not what I was expecting. If that occurs will I be able to do it in a less controlled local anesthesia situation? Will I need to stop and have the patient come back for another procedure? Would that meet your goals or only be more frustrating?

West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Rib graft removal should be done under general anesthesia

It is very difficult to go in and remove rib grafts from the nose since they get tissue ingrowth and are solidified with the healing process inside the nose.  This cannot be done under local anesthesia.  It can be done through a closed rhinoplasty technique under general anesthesia and since it is a revision, it is always more difficult than the primary rhinoplasty.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Graft removal in nose

It is usually better for y out o go to your original surgeon to have the grafts removed. He/She would lnwo exactly how they were placed.  Usually the grafts if sewn in are best removed through an open approach. Usually with sedation.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Is Graft Removal Hard and Can it be Done with Local Anesthesia??

The real question is "do you want the grafts removed under a local anesthesia"?  Probably not.  The real issues with having a local anesthesia for any Rhinoplasty procedure are the following:

1. The nose can bleed profusely and if that occurs without airway support and protection, you could wind up miserable, choking on the blood and in the worst case scenario, with a pneumonia from the aspirated blood.

2. Local anesthesia only numbs the pain nerves and you'll be fully awake and aware of all the things happening to your nose which could be unsettling.

3. Removing the rib grafts will require the same exposure that a Revision Rhinoplasty requires and once removed may require a straight silastic dorsal graft or some other technique to compensate for the soome volume of the removed grafts.  Thius all takes time and all while you're laying there awake.

IMHO, of performing Rhinoplasty and Revision Rhinoplasty for well over 20 years, local anesthesia for Rhinoplasty sounds way better than it actually is and I won't agree to do that to my patients.  Just MHO of course.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Is Graft Removal Hard and Can it be Done with Local Anesthesia??

Most likely you will need an open rhinoplasty and it can be done under local with a little sedation. The difficulty of removal can only be determined during the surgery. It all depends on how it was put in and how long it's been there.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 reviews

Revision of grafts after Rhinoplasty

Revision  or removal of grafts can be performed after Rhinoplasty. As to weather it can be accomplished under local that depends of where and how the grafts were placed and secured.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

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.