Healing Time with a Rib Graft?

Question

I had secondary rhinoplasty with a rib graft. It's been a year and half. The nose still feels stiff. The appearance of the nose is still too big for my tastes. My doctor says I'm still swollen and that it will take 2-3 years before I will get a final result. Is this true? Do I have to wait that long before I decided if I should have it adjusted to make it smaller? Thanks.

Ronald Schuster, MD · Answer

1 - 1/2 years is plenty of time to be able to evaluate your results. It is normal for it to feel a bit stiff, but I wouldn't expect much change in size or shape at this point.

Ali Sajjadian, MD, FACS · Answer

Dear Bob,

	 

	Usually, rib grafts require a relatively long time for healing to be completed so final results resolve.

	 

	Nonetheless, a year and a half is somewhat close to enough for all your swelling to subside but it may be possible that the cartilage resorption happens with time; every patient is different and the degree of resorption fluctuates pretty well.

	 

	I encourage you to seek consultation with a board certified surgeon of ample experience in facial surgeries/rhinoplasty if you think you have made up your mind about adjusting your nose.

	 

	Rhinoplasty revisions are delicate and should addressed by the right surgeon.

	 

	Best of wishes to you and thank you for your question.

	Dr. Sajjadian

Barry L. Eppley, MD, DMD · Answer

Depending upon the type of rib graft reconstruction (dorsal vs dorsocolumellar), your nose will always feel more stiff than it used to. At this point after surgery, you are looking at the final result. If you feel it is too big, a revisional procedure can be done to reduce its overall size and profile.

Vincent P. Marin, MD, FACS · Answer

There is no question that a rib graft surgery takes longer time to heal and resolve the swelling associated with the procedure. However, 1.5 years is approaching full resolution. If there are subtle issues, I would encourage you to wait. If you are more concerned about the appearance, then I would suggest discussing this with your doctor to determine the appropriate next step. With a rib graft, you will likely always feel your nose to be somewhat stiff.

Best of luck,

Vincent Marin, MD
San Diego Plastic Surgeon

Best of luck,

Vincent Marin, MD
	San Diego Plastic Surgeon

Alexander Ovchinsky, MD · Answer

There should not be any swelling a year and a halft after rhinoplasty. What your doctor probably implies is that the rib cartilage may slightly resorb with time thus decreasing the fullness of your nose. The degree of cartilage resorbtion is unpredictable, and the fact whether it actually resorbs or not is still debatable. So, if the size of the graft is not a big bother and you are willing to live with it then do so. On the other hand, if you are trully unhappy, then consider a revision(either downsizing the cartilage or replacing it altogehter).

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

I don't think your nose will change much at this point. Most if not all your swelling is gone by now. If the implant doesn't look right you may want to consider revising it.

Best,

Dr.S.

Richard W. Fleming, MD (retired) · Answer

1.5 years after a rib graft to the nose you can evaluate your result. There may be subtle changes in the future but it does sound like you want more than that. Talk to you surgeon or get a second opinion.

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