Mid vault collapse after rhinoplasty. How difficult is this to correct? (Photo)

Question

I had a closed rhinoplasty 4 months ago and i have notice since the cast went off that may upper lateral cartilages have collapsed and i looks indented from the front. How difficult is this to correct and what kind of graft are needed ?

Nima Shemirani, MD · Answer

Dear Andrepv97,Thank you for question and photos. The arrows you have drawn are pointing to your nasal bone and I would suggest waiting for another 6-8 months to see the final results of your nose. There is still swelling in the nose at this point, making it difficult to assess how your final nose will turn out.I recommend meeting with your surgeon when the swelling has subsided or getting a second opinion at that time. Best regards,Nima Shemirani

Toby Mayer, MD · Answer

Upper lateral cartilage collapse at 4 months? No--thhis is narrowed nasal bones and you need to wait at least another 6 months to know what exact treatment needs to be done. This nose is swollen for at least 1 year.

William Portuese, MD · Answer

Revision rhinoplasty is more difficult than a primary rhinoplasty, so it's important to choose your surgeon  very wisely based upon extensive experience. It's also important to wait at least one year to allow full healing to take place before embarking on another procedure. If the nasal bones are too wide, osteotomies are required. If there is a mid-vault collapse of the upper lateral cartilages, spreader grafts are required. Sometimes both procedures are required during a revision rhinoplasty procedure. For more information about spreader grafts, please see the link and the video below

David Alessi, MD - Account Suspended · Answer

The places that are being pointed to appear to be the lateral osteotomies (boney cuts).  The lining of the bone is still swollen and it will change over the next several months.  If it is the upper lateral cartilages being to far medialized, a spreader graft would help.  If it is a boney defect from the osteotomies, then grafting would probably be helpful.  I'd suggest waiting a  couple more months and then get re-examined by the surgeon or get a second opinion.  Best wishes.

Richard W. Fleming, MD (retired) · Answer

Your entire nose is narrow at this time, including the mid-vault. I suggest you wait another 4-6 months before evaluating both the appearance and nasal breathing. In a patient ho has true narrowing of only the mid portion of the nose, frequently spreader grafts are necessary.

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