Are grafts used in preservation rhinoplasty ?

Question

Hello, I was wondering if grafts are less used in preservation rhinoplasty compared to normal traditional rhinoplasty ?

Oakley Smith, MD, FRCSC · Answer

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination. Yes, they are less used in preservation technique.

Eric M. Joseph, MD · Answer

"Preservation rhinoplasty" is an alternative rhinoplasty technique for deprojecting the bridge of the nose.  If somebody requires correction of a droopy nasal tip, or if they have thick nasal skin, cartilage grafting to the tip may still be indicated. I hope this answers your question. Sincerely, Dr Joseph

Zeshaan Maan, MD · Answer

Preservation rhinoplasty can be partial or complete, and the choice is dependant on the nature of the patient's anatomy and their desired outcome. The possible components that can be preserved include the skin envelope, the dorsum, and the tip. In my practice, I aim for complete preservation, but adjust my approach on a personalized basis for my patients. 
1. Preserving the skin envelope means dissecting in the deepest plane right on top of the cartilage - this prevents thinning of the soft tissue and limits bruising and swelling. The impact on whether grafts are needed is minimal. 
2. Preserving the dorsum means not taking apart the normal cartilage and ligaments that make up the majority of the bridge of the nose, and lowering the bridge from underneath. This has a significant impact on the need for grafts, in particular spreader grafts. 
3. Preserving the tip means not excising any of the tip cartilage and relying primarily on suturing for shaping and positioning. However, even in a complete closed preservation, a columellar strut graft is not uncommon. 
So, in summary, yes preservation generally reduces the need for grafts, but they are still an excellent complement.

Ronald J. Edelson, MD · Answer

Overall I think surgeons do too
Many cartilage grafts which don’t do anything but can cause trouble later.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. When good technique is used, all types of rhinoplasty should involve structural support grafts. 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

Are grafts used in preservation rhinoplasty ?

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Are grafts used in preservation rhinoplasty ?

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