Alar rim/batten/composite grafts - what are the ways these can fail?

Question

What are the ways these can fail? Can the cartilage fall out after 2 weeks

Ali Sajjadian, MD, FACS · Answer

Thanks Brave632650 for your question! Complications can arise with alar rim grafts, regardless of whether they are composite or basic cartilage grafts. While it's less common for a graft to fall out completely after just two weeks, it's not entirely impossible, especially if there are underlying issues like poor blood supply or infection.  
-The following are some possible reasons why these grafts could not succeed:
-Partial graft Resorption: This happens often, particularly with tiny grafts. Over time, part of the cartilage may be absorbed by the body, specially if it was traumatized.
-Complete graft Resorption:  Although less often, it may occur if the graft is not correctly fastened or if there are serious problems with the blood supply.
-Inflammation, discomfort, and even graft loss can result from infection. To reduce the danger of infection, it's critical to carefully follow post-operative care guidelines.
-Poor Blood Supply: The graft may not heal correctly and may become necrotic (tissue death) if it does not receive enough blood flow.
-Displacement: If the graft moves from its intended location, it might cause problems both aesthetically and functionally.
-Failure of the Skin Graft: When composite grafts are used, the skin component may not adhere, exposing the underlying cartilage.

Selecting a skilled surgeon is crucial to reducing the chance of transplant failure.   
You should Follow your surgeon's instructions on medication, wound care, and activity limitations.  Smoking raises the risk of problems and hinders recovery. finally, Maintain Good Hygiene to avoid infection, keep the surgery site dry and clean.   
It is important to speak with your surgeon if you have any concerns with your alar rim graft. They are able to evaluate your particular circumstance and offer pertinent guidance.Usually with time they get better.
Remember, open communication with your surgeon is key to a successful recovery.
As a triple Board-Certified Plastic Surgeon and experienced rhinoplasty surgeon, I specialize in revision rhinoplasty. This complex procedure requires meticulous attention to detail and a deep understanding of facial and nasal anatomy. I am committed to correcting imperfections and restoring both the form and function of the nose. My philospphy is to listen carefully to the goals and desirers of my patients with a focus on patient satisfaction, I utilize advanced techniques to achieve natural-looking and long-lasting results.

Hope this was helpful!
Best wishes,
Dr Ali Sajjadian 
TRIPLE Board Certified Plastic Surgeon

Eric M. Joseph, MD · Answer

The grafts that you enumerate are typically used for both aesthetic and functional purposes. If they fail to lead to a desired result, either cosmetically or functionally, that is how they can fail. I hope this helps! Sincerely, Dr Joseph

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. When alar contour grafts or alar rim grafts are appropriately placed they should not fall out and should provide adequate support. It is important not to make them overly stiff or rigid. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Alar rim/batten/composite grafts - what are the ways these can fail?

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