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

            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

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. 

  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.

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.