Graft fixation. Is there any way to close the pocket to keep the rib graft straight? (Photo)

Question

I hope someone can help me, and tell me there is a way to close the pocket to keep the rib graft straight without having to go through another invasive open rhinoplasty. I don’t anything other than my original healthy, functioning, aesthetically pleasant nose with a STRAIGHT bridge. This is starting to take its toll on me mentally and emotionally and causing me to not want to face another day.

Jeffrey H. Spiegel, MD · Answer

Let's speak about this.  The rib graft pocket is above the bone it seems. This makes the graft mobile. We can likely address this in the office with local anesthesia.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, a revision rhinoplasty is the best way to address this. If you have a solid dorsal onlay graft previously placed, this is very common for it to be asymmetric and it needs to be removed and replaced with diced cartilage wrapped in fascia. With good surgical technique, you could have an outstanding result. 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

Graft fixation. Is there any way to close the pocket to keep the rib graft straight? (Photo)

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