Revision with fat grafting enough to build bridge and correct deformities? (Photo)

Question

I had septorhinoplasty with turbinate reduction in 2009 and would like to get revision rhinoplasty but do not want to do anything invasive. I’ve tried fillers twice and they barely work. Will fat grafts help the v-line deformity, Wall collapse and saddle bridge? If not, can a closed approach work with the most minimal work? Would like to build nose back up, not make smaller.

Thomas A. Mustoe, MD, FACS · Answer

I have had a great deal of success with fat grafting to correct minor asymmetries and depressions in the nose: and it has lasted many years if not permanently, unlike fillers.  However, it is of very limited use to correct larger depressions, and will not increase projection.  Your pictures are hard to evaluate, and an in person examination would be necessary to give you firm advice, but it does appear that a V-line deformity, and slight depression could be improved with a high likelihood.

Peyman Solieman, MD · Answer

Thank you for expressing your concerns. When the bridge is scooped out too drastically, it leads to an imbalanced facial profile, and in your case an inverted V deformity. It is important to understand that this often casues not only an aesthetic issue but also functional breathing problems. To correct the bridge's structure, the bridge often needs to be restored with intricate cartilage grafts, among other techniques. Once normal structures are damaged, cartilage must be extracted from the septum, ear or rib to recreate lost tissues and connections. I recommend visiting a board-certified facial plastic surgeon with expertise in revision rhinoplasty to address your condition. Non-surgical filler treatments can often help restore some of the aesthetic issues but they will not correct the breathing problems. The same would like be said of fat transfer as filler.

William Portuese, MD · Answer

Fat grafts will not work in the nose. To build up the nose requires cartilage grafts harvested from the back of the nose. If there's a cartilage depleted nose from a previous septoplasty, then consider ear cartilage. The wide nasal bones are treated with osteotomies to narrow them. The concave upper lateral cartilages are treated with a spreader graft. A closed rhinoplasty approach can accomplish making all the required changes to the nose. For many examples, please see the link below to our closed rhinoplasty photo gallery

George Commons, MD (retired) · Answer

Generally a more sturdy substance is needed for the nose; fat does not work well.   Cartilage,  fascia,  dermis and bone will give a lasting result.  My Best,  Dr Commons

Revision with fat grafting enough to build bridge and correct deformities? (Photo)

Answers (4)

Answer: Fat grafts questionable in nose

Answer: Fat grafts questionable in nose

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Revision with fat grafting enough to build bridge and correct deformities? (Photo)

Answers (4)

Answer: Fat grafts questionable in nose

Answer: Fat grafts questionable in nose

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.