What will happen to nosetip if rib graft cartilage is removed? Reverse rib cartilage revision rhinoplasty (Photo)

Question

Can someone please explain what will happen to the nosetip and columella if the rib graft has to be removed without replacing it with any other graft (no septum cartilage available). How would you approach this? Would you use fat injection or soft tissue to make the nose look at least "normal"? (Rib is used as: Spreader grafts, dome build, valve, nosetip and columella). Is there a chance the nosetip will still stay bulbous? And a bit high? I feel like no doctor is doing this procedure.

Callum Faris, MD · Answer

If the rib graft supports the tip its removal will result in a deprojected tip which will be more round and less defined. The question is why is it necessary to remove the rib graft?Is it infected?Fat grafting will give projection but the tip will not be defined - it will remain bulbous and blunted. Cartilage from the ear is an alternative but a careful clinical assessment needs to be made first.

Eric M. Joseph, MD · Answer

Based on your profile photo, you appear to have a pleasing nasal appearance so it’s not clear why you want to remove cartilage grafting material. In general, revision rhinoplasty is more difficult when there is extensive cartilage grafting. Consider Re asking your question with goals you would like to achieve. Hope this helps! Dr Joseph

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Afternoon! If you remove rib cartilage and replace it with fat injections or soft tissue, the nose would likely lose a substantial amount of its form. Both fat and soft tissue aren't used for support. Rib cartilage is strong and provides excellent structure to keep the nose in an ideal position. Ear cartilage is softer and can be used as a replacement option - though, it's not ideal. I would advise against total removal of cartilage. Improving the graft shape, size, and orientation are better choices. Hope this helps!

What will happen to nosetip if rib graft cartilage is removed? Reverse rib cartilage revision rhinoplasty (Photo)

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What will happen to nosetip if rib graft cartilage is removed? Reverse rib cartilage revision rhinoplasty (Photo)

Answers (3)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.