Revision rhinoplasty with cartilage gone wrong or too early to judge? (photo)

Question

I have done Revision Rhinoplasty with Ear Cartilage graft 3 weeks ago. After 5 days my splint was removed I noticed the graft is more on the left side . I was told by doctor to do a special massage . I don't know wether I am panicking and it need some time to settle or I need a revision . My doctor said it should be fine but if it doesn't change in three month he will fix it . This is really stressing me out :( so I need an advice from experts .

William Portuese, MD · Answer

At three weeks, there is still lots of swelling in the nose so it's still very early in the healing process. It's impossible to make a final determination about the shape of the nose at only three weeks into the process, since full healing takes one year. Revision rhinoplasty and ear cartilage  grafts, take a long time to settle in and go through the full healing process. Consider a revision rhinoplasty if it is still crooked at one year. Revision rhinoplasty is very complicated, so choose  your specialist wisely based on extensive experience

Tom D. Wang, MD, FACS · Answer

Hi there, thanks for sending the photos.  It does appear the dorsal cartilage implant may have shifted off to the left.  You should follow your surgeon's advice and massage the area as instructed as this may help improve the position.  As you've noted, this can be corrected if it is still off center after three months, recognizing of course no one wants to undergo another procedure unless necessary and indicated.  Best of luck to you!

Robert E. Zaworski, MD (retired) · Answer

Revision rhinoplasty may be indicated.  At 2 weeks post op, it is too early to consider revision surgery.  Your surgeon can show you how to train the nose to heal in the center of your face.  Follow up with your surgeon so he can monitor your progress.

Robert J. Troell, MD, FACS - Account Suspended · Answer

Good Day. Thank you for your question. I understand your anxiety, especially with the photographic appearance.Frequent followup visits are important so you and your surgeon can judge if your massage and swelling resolution is approaching your desired outcome.However, given the description of your procedure (ear cartilage graft to your nasal dorsum), it does appear that the cartilage graft has been displaced to the left side. Early revision may be best to minimize the difficulty with scar dissection and replacement of the graft to a more optimal position.While I was at Stanford University, we showed that early intervention prior to five weeks was essential or waiting to 2 1/2 to 3 months. The dissection during the interval period is extremely difficult.Your surgeon can discuss the advantages and disadvantages of surgery at this time. Since he/she is the surgeon who completed the procedure, your surgeon is the best to determine if and when the revision should be contemplated or performed.In summary, see your rhinoplasty surgeon and receive the surgeons guesstimate on resolution with or without intervention. All concerns can be treated. Close followup is essential to give the most options when a less than optimal result occurs.

Revision rhinoplasty with cartilage gone wrong or too early to judge? (photo)

Answers (4)

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