Can a septum redeviate due to cartilage memory and can this be alleviated by using a flat piece of cartilage from a rib graft?

Question

I had a septorhinoplasty (rhino portion corrected significant nasal hump) and since then my nose has significantly curved to the right again. I want to get this corrected but was wondering if a rib graft that uses a very flat piece of cartilage would be a more promising method to make sure the septum does not deviate again. I am not sure how much cartilage even remains in my septum. I can also feel my pulse on the right side of the tip of my nose where there is fullness.

Andrew P. Trussler, MD · Answer

Deviation after septorhinoplasty is common secondary to the inherent warping of cartilage through the healing process. A septoplasty alone can lead to further deviation depending on what method of septoplasty that was performed. Spreader grafts either from the septum or from the rib can help bolster the septum and prevent warping and/or chance of deviation. It all depends on how much native septum there is which can be estimated with a thorough consultation.

Kaete A. Archer, MD · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Making plans for rhinoplasty depends not only on the outside of the nose but also the inside of the nose and the feel of the nose (skin thickness and cartilage strength).  Based on
your description, I agree with you, you could definitely benefit from a straight piece of rib cartilage, especially for a revision rhinoplasty.  These decisions should
be based on a detailed discussion with equal input from both you
and your surgeon. Good luck and best wishes.

Robert S. Schmidt, MD · Answer

Thanks for your question. You are right on. More likely than not you'd need a piece of rib cartilage to straighten the bent area. The cartilage can come from your rib cage or from a cadaver. You and your surgeon can talk about the benefits of each. In an ideal world, you'd have enough in your septum but this can't be guaranteed, so planning this way makes a lot of sense. Good luck with your surgery. Be sure to go with a surgeon who is experienced in revision cases.

Can a septum redeviate due to cartilage memory and can this be alleviated by using a flat piece of cartilage from a rib graft?

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Can a septum redeviate due to cartilage memory and can this be alleviated by using a flat piece of cartilage from a rib graft?

Answers (3)

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