Revision rhinoplasty graft. From nose "not smooth" result? (photo)

Hello, my first rhinoplasty went wrong and I have problem to breath. I am ready for revision with a specialist, but he gave me a choice. He asked me to tell him if I am a perfectionist or woman who don't see every little details in her face. He will be able to use grift from my nose or he can use implant. Implant will give me perfect result but there is risk of infection (4%) and graft from my nose can not be smooth. What is not smooth? Will I see it or feel it? I would prefere my own material.Thank you

Doctor Answers 9

Revision Rhinoplasty Graft


In your case, grafting material can consist of cartilage and/or fascial graft material to smooth out or straighten the dorsum of your nose. However, additional grafts may be needed to improve your breathing. This can only be evaluated during an office visit.



New York Facial Plastic Surgeon
4.8 out of 5 stars 263 reviews

Revision Rhinoplasty Concerns

Thanks for your questions. From the information you posted I would respectfully suggest that you get another opinion from a physician who specializes in complex revision rhinoplasty cases. Breathing and cosmetic concerns may require advanced reconstruction rhinoplasty techniques through an open approach for graft placement. Natural cartilage sources ( your own material ) like nose, rib or ear cartilage are best, but sometime implants, donor cartilage or acellular tissue are required to correct complex cases. Please search for a Facial Plastic Surgery specialist and consult in person to help you plan your next step. Best wishes. 

Fred J. Bressler, MD, FACS
Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews


Using foreign material in a primary rhinoplasty has problems of infection, extrusion, etc.

The risks of using foreign material in a revision are magnified.

I suggest you find someone who will use your own cartilage for raising your bridge.

Dennis Barek, MD
Great Neck Plastic Surgeon
5.0 out of 5 stars 6 reviews


Thank you for the question and photograph.  In the USA, your own tissue is preferred over an implant.  In Asia, implants are more common than your own tissue.  Temple fascia with diced cartilage (DCF) can give a smooth result similar to an implant.  The advantages of DCF grafts are less risk of infection and less movement than implants.  DCF grafts integrate very quickly and feel natural.  

Raj P. TerKonda, MD, FACS
Beverly Hills Facial Plastic Surgeon

Revision Rhinoplasty Graft or Implant

Both can provide the desired result but I prefer to use the patient's own tissue to decrease the risks of infection, movement, and possible extrusion associated with synthetic materials. Make sure that your surgeon addresses the breathing problems you describe.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision rhinoplasty

It looks like from the profile that your nose needs augmentation. I prefer to use rib cartilage from you own body or irradiated cartilage.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Revision rhinoplasty graft

It is true that an implant will be perfectly smooth but carries some more risks. I rarely use them because the results with cartilage grafting are usually very close in the end with fewer risks. I would suggest meeting with a few different revision rhinoplasty surgeons as this is a very complex operation. 

Best of luck

David Reinstadler, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Implant Or Material From Own Nose

Thank you for asking a good question. In my practice, I have used material from the patient's own body and have produced smooth results. Perhaps you should have a few more consultations if you have unanswered questions and are concerned that your result will not be to your liking.

Revision Rhinoplasty - Implant vs. Graft

Due to the complex nature of revision rhinoplasty, additional material is often necessary in order to achieve a good result. Many surgeons use synthetic implants in these cases and it is certainly possible to get a good result using such implants in the correct type of patient. I believe, however, that there is a better option. I have never used a synthetic implant in the nose because I'm a rhinoplasty purest and I don't like the potential longterm complications. Excellent results can be achieved in revision rhinoplasty using a small amount of a patient's own rib cartilage. Rib cartilage can be carved into any shape and size and most importantly it becomes living tissue that is incorporated into the surrounding tissue. This provides for an extremely low longterm complication profile. If there are concerns about smoothness, this can be addressed by using soft tissue grafts (fascia) as overlay camouflage grafts.

Robert Morin, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.