How predictable are alar rim grafts? Is their longevity closer to 1, 5, or 10 years?

In general, cartilage grafts are one of most reliable grafting material available in reconstructive surgery; using allar cartilage grafts for correction of retracted alla is the most appropriate and predictable way of correction in hands of an experienced rhinoplasty surgeon. Correction with soft tissue fillers, in particular one as unpredictable as silicone, is not reliable and may actually be very dangerous in inexperienced hands. There is no time limit on cartilage grafts; they do not loose volume and in this particular area they will retain the shape for ever. I hope this answers the question which surgeon to trust. Good luck.

 Revision rhinoplasty more difficult than a primary rhinoplasty due to the fact that there have been previous alterations to the normal anatomy, scar tissue present, and thick skin.  In our practice, alar retraction is usually treated with a composite graft harvested from the ear. If there's a collapsing of the alar rim with inspiration, then an alar rim graft can be of some benefit. Once the cartilage grafts are placed and live, they last forever. We do not recommend silicone injections in the nose