Can alar rim grafts be removed?

Question

I have naturally very tall nostrils so I was considering alar rim grafts. I’m concerned, however, that I won’t like them. If I don’t, can they be removed? Will my nose be the same after they’re removed or will there be scar tissue or something like that making my nose look different?

Zoran Potparic, MD · Answer

It is very difficult to discuss issue like this without series of good photos and/or in person evaluation. Generally speaking, allar grafts (there are different options) are used to support and shape nostril rim. If they are removed, there should be no long lasting effect, except that previous condition will come back to a certain degree. Only on the basis of in person consultation a board certified plastic surgeon, expert in rhinoplasty, may properly answer your question. Good luck.

Gurkan Kayabasoglu, MD · Answer

Hello,It is difficult to make any assessments without any photos, however, ı can say that alar rim grafts is often performed to prevent or correct alar concavity and stability. When they are removed, there will be no long lasting affect comparing to previous condition. An in-person examination is needed to make certain assessments.You need to seek a professional, expert facial plastic surgeon to get balanced, natural look.Good Luck,

Ronald J. Edelson, MD · Answer

I think you need to consult with a plastic surgeon to see if you are actually a candidate for the procedure. For most rhinoplasties it is very seldom used especially fir a first time procedure. And most plastic surgeons rarely do it. So it’s starting to sound like it’s unlikely that you would have the procedure recommended.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It would be helpful to view pictures of your nose. Alar rim grafts are placed to help prevent alar rim collapse and alar retraction. If you have elongated nostrils, then you may be a better candidate for a nasal tip deprojection. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon. If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. I recommend that you seek consultation with a qualified board-certified plastic surgeon or facial plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Farhad Rafizadeh, MD · Answer

Alar rim grafts are used for very specific reasons, for example to correct the notching of the alar rim. They give more rigidity to the external nasal valves. They are not visible and if used for proper indications, do not produce a negative effect. Removing a cartilage graft can be done to correct a functional or aesthetic problem related to their use. Like any revision rhinoplasty, there are risks of further deformities, and it would be best to use cartilage grafts judiciously in order to avoid the need for their removal.

Pejman Aflaki, MD · Answer

Hello and thank you for your question. Rhinoplasty is a surgery of millimeters, in which every aspect of the surgery has to be carefully planned and executed. As complex as every rhinoplasty operation is, revision rhinoplasty, for example to remove previous cartilage graft, carries an extra-level of complexity and cannot be approached casually. Therefore, it's in everyone's best interest to get it right the first time. Alar rim grafts are used to support a weak alar rim, where there is collapse or alar notching among other reasons. If you are considering rhinoplasty, my best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Daniel Zeichner, MD · Answer

Hi and welcome to our forum!Alar rim grafting is performed to provide support to the external nasal valve and for improving nasal base contour. If dissatisfied with the result, ihe grafts can be removed. I would advise waiting 6 months to a year before contemplating removal as postoperative swelling in this area may be significant for some time camouflaging the final result.Seek a consultation with a board certified plastic surgeon for evaluation and discussion.Best wishes...

Steven Wallach, MD · Answer

These are grafts that are used to support the shape of the alar rims. They can often make them feel a bit firm. They can be removed, but not all patients need them.

Robert L. Kraft, MD, FACS · Answer

The nose is a complex structure and all the components of rhinoplasty come together as a whole. It is difficult to adjust the nose by removing alar cartridge which was placed to lend structure to the nasal tip.

Harrison C. Putman III, MD (retired) · Answer

Of course alar rim grafts can be surgically removed, but the question is whether you need them in the first place. Photos would be helpful, but as an alternative seek a second opinion from a board certified FPS or PS rhinoplasty expert.