Can Grafts Be Added in Revision Surgery to Give a Softer, More Fuller Appearance? (photo)

My nostrils feel quite thin however the middle of my nose is still quite bulky and so appears slightly notched. I am now 10 months post op. Will i need to undergo a revision surgery with the use of grafting in the alar rim to smooth out the dents and lower and strengthen the nostril tissue? [Before and after]

Doctor Answers 6

Can Grafts Be Added in Revision Surgery to Give a Softer, More Fuller Appearance?

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Yes revision rhinoplasty surgery is an option for you at this time. I suggest a few in person evaluations to see the best route/plan to follow. Best of luck. 

Alar rim grafts

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Based on your photos it appears that you would be a good candidate for revision surgery with alar rim grafts and tip revision

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Grafts in Revision Surgery #nosejob

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I could not agree more with my colleague on this one. You certainly should wait at least one year before revision surgery and you should choose a skilled surgeon in this area. This is my favorite operation in my specialty and I do a lot of them. You would benefit for sure form cartilage grafts that fit along the rounded part of the nostril, called the ala. These are placed beneath the skin and can help alleviate the denting that you are seeing. The physical exam is the most important to any Rhinoplasty procedure so it is really hard for me to tell you more. I would also use your septal cartilage if it is still there. Good luck!!

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Alar Rim Grafts

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Alar rim grafts will be necessary to correct the retraction of the edges of your nostrils. Your bulbous tip can also be improved. It is difficult to further evaluate your nose without additional pictures.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Alar rim grafts will help

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i agree that alar rim grafts will help soften the soft triangle and improve your appearance of your nasal tip. 

i would wait at least one year post your surgery before re operating. Good luck. 


Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 48 reviews

Grafts can smooth nasal contours

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Alar rim grafts can smooth the transition between the nasal tip and nostrils.  They soften the shadows on each side of your tip.  They can also slightly improve the contour of alar rims that are notched or have a sharp angle.  Septal cartilage works best.  Keep in mind you have rather thin skin, and your tip cartilages are oriented more vertically than horizontally, which contribute to the bulky, notched appearance that you mention.  Changing the position of the tip cartilages, padding the tip and supratip with connective tissue, and placing alar rim grafts would most likely give you the result that you are looking for.  Always think carefully and wait 12 months or more before pursuing revision surgery.     

Michael Fozo, MD, FACS
Detroit Facial Plastic Surgeon
4.4 out of 5 stars 17 reviews

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