What is this graft sticking out and why is it moving? (photo)

Question

My ENT surgeon put some tip graft in the collumella and now I see it sticking out and moving around, why did he put that there and can I get it out? what will happen if I have someone take it out? its obviously not helping me if its going to be moving around and sticking out!

Jose M. Soler-Baillo, MD, MS · Answer

Your surgeon is the only one who can answer that question. Go see him/her and ask the reasoning for it and why it is moving around.All the best,Dr. ResultsMiami, FL

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns with us.After having analyzed all the info. and photo provided to us, I can realize that probably the nasal graft has moved.In this regard, I recommend removing and consider perform other graft more stable, to improve the columellar area.Respectfully,Dr. Emmanuel Mallol Cotes.-

Afshin Parhiscar, MD · Answer

Dear butterfly3443From the picture it looks like a columellar strut graft that is too short and did not reach you nasal spine. If it doesn't show when you are not touching your nose, leave it alone. In the picture, it shows when you are forcing tip rotation and chances are your surgeon sutured this graft to the medial crura. If it doesn't show at rest, leave it, if it shows at rest, look for a revision rhinoplasty (it might be a very limited procedure based on rest of findings).

Guy Watts, MBBS (Hons), FRACS (Plast) · Answer

The graft you are talking about is a columella strut graft and one of the most common cartilage grafts used in rhinoplasty. The position that your are demonstrating the graft is an unusual position for viewing the nose so the only real concern is if the graft is visible with the nose in its natural position. If it is visible you should return to your surgeon for a review. Removing the graft may create changes in the nasal tip shape and projection so be sure to discuss the consequences prior.RegardsDr Guy Watts

Zoran Potparic, MD · Answer

It is impossible to give you exact reason why your surgeon used this type of graft. It is frequently used in routine rhinoplasty to support nasal tip after tip cartilage refinement. It looks like lower end of the graft is slightly protruding when you push your nose tip up? It may not be visible when your tip is in it's normal position?You should discuss this problem with your surgeon. He can easily reposition graft or just trim this portion of cartilage graft. Good luck.

Steven Wallach, MD · Answer

It could be a columella strut but not sure without an exam. This can often be removed if it is causing a problem for you.

Stephen Weber MD, FACS · Answer

It's not obvious what the purpose of that that graft is. It could be a columella strut or an infratip graft. Either way, if it's visible and troubling you it can be removed in the office under local anesthesia. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Vasdev Rai, MD · Answer

Your graft is not doing anything.  Have it taken out.  It can be removed. You will be better of without it.

Brian J. Reagan, MD · Answer

If that is a tip graft, it is a long ways from home.  More likely that is a columellar strut used for tip projection which has migrated.  It can be revised or resected most likey under local anesthesia.  Return to your surgeon for a discussion of your options.All the Best,Dr. Brian Reagan

Remus Repta, MD · Answer

Thank you for the question and photo.  A comprehensive exam and review of your prior rhinoplasty operative report or discussion with your prior surgeon will be needed to know what the graft is and what it is intended to do.  Only when this is done can knowing if removal will have an impact on your nose shape.All the best,Dr. Remus Repta

What is this graft sticking out and why is it moving? (photo)

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