How Does The Grafting Procedure Work in Revision Rhinoplasty?

From what part (or parts) of the body can the tissue be taken for a nose job revision? 

Doctor Answers 8

Source of Tissue Grafts for Revision Rhinoplasty

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

There are several sources for tissue used in both primary and revision rhinioplasty. Depending on quantity and availability, cartilage is taken from the septum, ears, or ribs. When necessary, fascia is harvested from the    temporal scalp. Bone is rarely used, but can be taken from the skull. Your surgeon will describe the exactly what will be done before your surgery.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Grafting in revision rhinoplasty

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

Grafts are taken from multiple sources to perform a revision rhinoplasty.  The most common grafting material used to reconstruct the nose during a revision rhinoplasty is nasal cartilage.  If the nose is depleted of cartilage, then ear cartilage can be used.  Rib cartilage is rarely used but is an alternative source of cartilage.  Synthetic material, such as silastic can be an option, especially in Asian rhinoplasty.  Fascia can be harvested from the scalp to use as needed for soft tissue augmentation.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Grafting for revision rhinoplasty

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

Usually the septum. If that area has been exhausted or lacks sufficient cartilage, then ear or rib cartilage. I also like camouflaging grafts with temporal is fascia or perichondrium.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Grafting in Revision Rhinoplasty

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

Autologous cartilage (cartilage harvested from your own body) is the best grafting material to restore the framework of your nose .  Septal cartilage is my first choice.  But in many cases, there may not be enough available, or the cartilage from the septum may be compromised.   Rib cartilage is a great second choice. It is very strong, and much more rigid than ear cartilage, which is another option.  In addition, a far greater amount of rib cartilage can be harvested.  Regarding tissue, deep temporalis fascia is an excellent tissue that is easily harvested from a small incision made in the hairline. Thank you, and I hope this helps answer your question.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Grafting for Revisional Rhinoplasties

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

If structural support is needed for a rhinoplasty, cartilage is most often used. Cartilage may be obtained from the septum of the nose or back side of the ear. If bone were required, a portion of rib may be harvested. How these grafts are harvested and then secured is essential. Postoperative warping of the cartilage can occur if it was handeled, carved  or secured improperly. My advice is to seek out an experienced plastic surgeon for your rhinoplasty.

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Where are grafts taken from for revision rhinoplasty

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

Cartilage grafts are what is most commonly used during rhinoplasty (revision or otherwise). These can be harvested from the nasal septum, ear (conchal bowl), or rib (low rib near the sternum/breastbone).

In other cases pericondrium or periosteum (the tissue covering over cartilage or bone, respectively) or temporalis fascia (the tissue covering the temporalis muscle in the temple area above the ear) can also be used.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Cartilage for Rhinoplasty

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

The tissue obtained for rhinoplasty (including revision rhinoplasty) is usually cartilage.  The tissue is useful for supporting, strengthening, and shaping the nose.  Most commonly this cartilage is obtained from the septum while performing  the procedure.  In revision rhinoplasty this source of cartilage may not be available because of previous use.  Other sources of cartilage include  the ear and the rib.  Each of these sources has some benefits and drawbacks.

Rarely, one might use fascia from other areas in the body for rhinoplasty.  The fascia can be harvested from a number of different sites, but the temporal fascia (in the scalp) and  fascia in the lateral thigh are the most common areas.  One might also consider using acellular dermis (such as alloderm or allomax) which comes from a human donor in situations in which fascia is needed.  I hope this is helpful.

Eric T. Emerson, MD, FACS
Charlotte Plastic Surgeon
4.7 out of 5 stars 29 reviews

Cartilage from 3 places

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

When extra cartilage is needed to reinforce the changes made during a rhinoplasty (every rhinoplasty I perform, revision or otherwise) it can be taken from 3 areas.  There are pluses and minuses of each.

  • Septum- most like normal nose cartilage but has a limited supply
  • Ear- easy to access, cartilage is weak and floppy, sometimes hard to find straight pieces, slightly limited supply
  • Rib- nearly unlimited supply is the only advantage.  It is otherwise thick, heavy cartilage that cuts like a piece of chalk.  Painful to harvest and is known to warp over time.

John Bitner, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 92 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.