In Revision Rhinoplasty, Can You Remove Only Part of a Cartilage Graft?

I'm east asian and had rhinoplasty 7 months ago. My surgeon placed a cartilage graft (ear and septal) directly inside my nose (no dicing, no fascia or any other wrapping). I'm happy with the tip, but the bridge of my nose looks rigid and unnatural. I want to remove the rest of the cartilage and only preserve the tip. Is this achievable through a closed procedure? What are the odds of ugly scar contractures and other complications?

Doctor Answers 4

Any cartilage graft can be trimmed or removed

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Yes, the cartilage graft can be modified.  Whether done through an open or closed approach is a matter of surgeon's preference.  Scarring along the profile is a risk and can be worse with thin skin.  Have you talked to your surgeon?  He or she knows why these grafts were used and exactly where they were placed.  The primary surgeon is generally the best person to modify the result.

Boston Facial Plastic Surgeon

Graft removal revision rhinoplasty graft modification

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That is a very good question and a very practical one at that.  I would suggest allowing healing to take place as you normally would and allow the entire nose to settle out.  If there are persistent areas that appear  rigid or unnatural or unusual a modification should be quite possible.  The endonasal approach will allow the surgeon to access the nasal dorsum and perhaps gently take down the areas of fullness or irregularity.  However, I would recommend doing this after the nose has "declared itself "with the healing process.  He would not want to make adjustments and find out it was too soon and actually make things worse. 

Michael A. Carron, MD
Detroit Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

In Revision Rhinoplasty, Can You Remove Only Part of a Cartilage Graft?

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            Cartilage grafts on the dorsum can be removed through a closed approach without great difficulty, provided the skin envelope was not compromised during the previous surgery.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Revision rhinoplasty for cartilage graft removal

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  It is probably best to wait at least a year before undergoing a revision rhinoplasty to remove any cartilage grafts from the bridge and dorsum. The grafts can be removed on the dorsum and the skin should  heal quite well over the existing dorsum without the grafts.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 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.