Will a dorsal graft move when you touch it or it is attached to your nose bridge as if it's a part of your bone?

Question

I touched a nose whose undergone rhinoplasty using diced rib cartilage wrapped in fascia. I felt that her nose moved when I tried to push it left and right. Is this normal for a dorsal graft? When I try to push my own nose bridge left and right, it doesn't move with my figure. I just feel it as a bone attached to my face. I haven't had rhinoplasty but I am considering getting dorsal augmentation.

Kenneth Hughes, MD · Answer

Movement or rotation can always be a risk as can resorption and thinning out of nasal skin and visibility, palpability and extrusion.Kenneth Hughes, MDBeverly Hills, CA

Robert Kotler, MD, FACS · Answer

Dear BHills in Los Angeles:

Touching
the nose is helpful, but it is less important than how the nose looks.  Some people have cartilage implants that can
move, but when not moved, they are in a perfectly normal position.  The moveability is not a problem unless it is
causing some infection or reaction. 
Likewise, those who have had plastic bridges put into the nose may have
some mobility of the bridge, but again, it would not necessarily cause a
problem.  Sometimes the implants can be
fixed to the nasal bones, as you mentioned. 
Dorsal augmentation can come from a variety of sources, including
man-made inserts or implants.  Also
cartilage grafting.  As you indicated,
fascia and cartilage grafting.  Of
course, also temporary and permanent fillers are always an option if that is
the main issue.  If there are other
issues, such as a bulbous tip or crooked nose, surgical procedures may be
indicated.

There is
a lot to learn, so be sure to do your homework. 
Visit a lot of top-rated websites. 
Check out the doctor’s experience with these procedures.  You want somebody who is a super-specialist in
nasal surgery, nearly limits his practice to nasal surgery, of course, and a
computer imaging, reading reviews, and studying the website are all very
helpful.

Best wishes,

Robert
Kotler, MD, FACS

Over
4,500 nasal procedures performed

Michael R. Menachof, MD · Answer

The answer to your question depends on how far out after surgery you were feeling their nose. Initially, there can be some movement.  As things heal though, scar tissue forms around the graft securing it nicely in place. I hope this helps.

Robert H. Hunsaker, MD · Answer

It is most common NOT to secure the graft but to allow it to fit snugly into the dissected pocket. Ocassionally, some surgeons choose to place a small screw to secure the graft and is more common when rib cartilage or calvarial bone is used.

Richard W. Fleming, MD (retired) · Answer

After the graft has healed it should not move. This is an unusual complication when the diced cartilage is placed by an experienced specialist. Diced cartilage harvested from the septum or the ear wrapped in fascia is the  technique I prefer in most patients who need augmentation.

Will a dorsal graft move when you touch it or it is attached to your nose bridge as if it's a part of your bone?

Answers (5)

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