What's the best way to fix cartilage damage?

Question

7 months ago a punch to the nose caused my nose cartilage to become crooked in the left nostril. I can't breathe quite as well out of this nostril and I went to see a consultant who said the cartilage may correct itself with time but if not he could operate and create a spreader graft. Although the obstruction to my breathing is not always chronic it is a nuisance but I am concerned a spreader graft may make matters worse. Not sure what to do. How successful are spreader grafts?

Thomas J. Walker, MD, FACS · Answer

Without an evaluation in the office, it is impossible to answer your question accurately. Generally speaking, cartilage grafts are needed to correct nasal obstruction to open the airway and stabilize the nasal valve area. I don't think the your cartilage or bone will correct itself with time. If anything, I would anticipate the contrary to be the case that your nasal obstruction would get worse with time as with each inspiration, the nasal sidewalls tend to collapse in further weakening the cartilages. There are many different techniques to improve nasal breathing and each technique has its role for different underlying problems. Furthermore, most cartilage grafts are complementary to each other rather than one being used instead of the other. First, it is important to assess what the main cause for your nasal obstruction is. Only then can an adequate treatment plan be established. Spreader grafts are indeed very powerful grafts to improve nasal breathing if placed properly. However, they are usually not the only graft required to maximize nasal airflow nor are they necessarily the type of graft to best maximize nasal breathing. I recommend you see a rhinoplasty specialist who is well familiar with nasal airway dynamics to give you further recommendations. Good luck!

John Layke, DO, FACS · Answer

Usually once cartilage has been damaged, it often needs repair, as it may continue to warp and change over time.  Spreader grafts are utilized for certain indications, opening what rhinoplasty surgeons call the "internal valve" and successfully allow for easier breathing.  I would recommend seeing a Board-Certified Plastic Surgeon who will thoroughly examine you, create a "simulation" if you require any aesthetic changes, and formulate a plan tailored to your needs and wishes.  Good luck!

Gregory J. Vipond, MD, FRCSC · Answer

The nose is extremely easy to break and can definitely result in twisted cartilage. In general, this is best corrected with a rhinoplasty surgery. Spreader grafts can be very effective in helping to straighten a crooked septum and can definitely improve your breathing. The most appropriate surgical options would be best determined after a proper consultation. Since it has been over 6 months since the injury, it would be appropriate to perform the surgery at any point. However, it is always best to find a surgeon that is experience in nasal surgery, especially after trauma.

William Portuese, MD · Answer

Spreader grafts are composed of the patient's own cartilage harvested from inside the nose. They are used for both functional and cosmetic purposes to build up the upper lateral cartilage when it  has been fractured off the nasal bone and is concave and herniated into the airway. A spreader graft also helps open up the nasal valve internally to improve airflow through the nose for functional purposes. For  many examples and diagrams, please see link below

Steven Wallach, MD · Answer

I think that you need to be seen in person and require a proper exam to see what the problem is.  If your cartilage is bent it is doubtful that the cartilage would straighten on its own.

George T. Boris, MD, FRCS · Answer

Frequently spreader grafts are the correct answer for collapsed nasal cartilages. However, without examining you or seeing pictures, no one can really say. Rarely will cartilage reformat itself so that you can breathe better. When ever you operate on the nose you are going to encounter a time frame where scar formation decreases your ability to breathe but this shouldn't be permanent. As always, a good exam with a qualified experienced surgeon and getting his opinion is your best bet. Good luck! Unfortunately we are in California, you can always send us pictures and we can do a virtual consultation here at Boris Cosmetic.

What's the best way to fix cartilage damage?

Answers (6)

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