2 Hour In-Office Rib Graft Removal Using Open Technique Under Local Anesthesia

I had a Rib Revision Rhinoplasty using a columellar strut, dorsal graft, and spreader grafts in January 2011. The procedure has been very intense and has deformed my chest and left my nose hard, inflexible and painful. I requested a refund as well as my medical records, both of which my physician has refused to give me. My physician has countered my request by offering to remove the grafts in a 2 hour in-office procedure under local anest, using the open technique. Advice on how to proceed?

Doctor Answers 4

Revision rhinoplasty anesthesia options

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Anesthesia options for rhinoplasty vary generally among strict local, IV sedation, or general anesthesia. The decision on anesthesia type largely depends on the nature of the procedure, surgeon preference, and patient preference. Most plastic surgeon perform all rhinoplasty via general anesthesia or IV sedation. Minor procedures or revisions may be performed in the office with just local anesthesia. 

Only after a comprehensive evaluation can a rhinoplasty surgeon help determine appropriate options for you. You raise several issues with your question that cannot be adequately addressed in these forums. As other surgeons have already stated, typical rhinoplasty swelling after rib cartilage grafts may last much longer as compared to other cartilage grafts. Waiting longer before making a decision on revision rhinoplasty may be appropriate. Best of luck.

Dr. Chaboki


Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 reviews

Rib Graft Removal

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You raise several questions. First, all patients like youself have a right to a copy of their medical records; .Second, it is possible to remove rib cartilage grafts under local anesthesia; Third, I feel it is too soon to remove the grafts; Fourth, I feel getting a second opinion may be helpful.

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

Rib revision rhinoplasty

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Typically, rib grafts placed in the nose will soften over time. It is too early in my opinion to remove those grafts and I would wait at least 18 months before considering revising them or removing them. Patience can be difficult but it probably will improve a lot over time.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 20 reviews

Rib graft removal

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After such an extensive procedure I would recommend you wait 24 months before doing anything. You may yet get more pliability and softening of your nose.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 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.