Can I make my lower lateral cartilage fuller after my doctor removed too much? Asian Rhinoplasty

Question

My doctor removed 4mm total from the tip of my lower lateral cartilage to make my bulbous nose smaller. It was too aggressive and makes my nose look pinched. Also, the sides of my nose sinks in when I breathe. It is uncomfortable. I am asian so I want the tip rib cartilage removed to get my flat nose back and I just want to add back what was removed from my lower lateral cartilage. What can be done to make my lower lateral cartilage look "full" again and not "collapse" when I breathe?

Marc Polacco, MD · Answer

I'm sorry this happened. The maneuver performed to reduce bulbosity most likely was a cephalic trim. The important point is not how much cartilage was removed, but how much was preserved. If an insufficient amount is left behind, the nose will be at risk of collapse on inspiration (nasal valve collapse). While there are multiple ways to solve this issue, I would wager most rhinoplasty surgeons would use an articulated rim graft or a lateral crural extension graft. When you see your physician, ask about the techniques and approaches he or she would use, and has an appreciation for the interplay between form and function. Best of luck!

Vincent McGinniss, DO, FACS, FAOCO · Answer

Hi! I am so sorry to hear that you are unhappy with your rhinoplasty result. It is difficult to fully help you without photos, or better yet, an in person consultation to better understand what’s going on with your nose. In rhinoplasty, if we take away too much of the lower lateral cartilage, it can be weak and collapse. I like to leave 8mm of this cartilage at least. I even like to “fold in” and suture the part we would have otherwise removed to further stabilize this important structure. It sounds like you might have had an aggressive “cephalic trim” where we remove the top part of the lower lateral cartilage. This can be corrected, but it would likely require getting cartilage (from septal cartilage or whatever cartilage we still have in the nose or ear cartilage, sometimes rib cartilage) All my best!

Can I make my lower lateral cartilage fuller after my doctor removed too much? Asian Rhinoplasty

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Can I make my lower lateral cartilage fuller after my doctor removed too much? Asian Rhinoplasty

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