My straight/solid rib rhinoplasty is warped. I got the surgery done 7 months ago and the warping started week 8. My surgeon suggested shaving down the graft or screwing to the bone. Other surgeons advised against it pointing out the graft has a curvature and can’t be fix using either of these two methods. 1) What technique would you recommend? 2) And what is the absorption rate using your suggested method? This has been a very stressful journey so your advice will be very appreciated.
April 5, 2019
Answer: Warped cartilage graft Thank you for your photo. Unfortunately warping can happen to rib cartilage grafts. The graft may be able to be trimmed as long as the shape can be maintained with compromising the integrity of the remainder of the graft. It is unlikely screwing the graft will be beneficial as there is no bone in that part of the nose. You may be better served with a new graft placed or diced cartilage fascial grafting to minimize the risk of warping. Hope this helps!Johnson C. Lee, MD Board-Certified Plastic Surgeon
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April 5, 2019
Answer: Warped cartilage graft Thank you for your photo. Unfortunately warping can happen to rib cartilage grafts. The graft may be able to be trimmed as long as the shape can be maintained with compromising the integrity of the remainder of the graft. It is unlikely screwing the graft will be beneficial as there is no bone in that part of the nose. You may be better served with a new graft placed or diced cartilage fascial grafting to minimize the risk of warping. Hope this helps!Johnson C. Lee, MD Board-Certified Plastic Surgeon
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April 5, 2019
Answer: Revision Rhinoplasty / Rib Graft hi d_d, I have been performing revision rhinoplasty as a speciality of mine for over the past ten years and have seen this complication come into my office often from other surgeons quite often. You would never screw the graft in as it is warped. In my opinion the caudal (lower) aspect of the rib cartilage is warped upwards and needs to be shaved down. I believe this is an easy fix. But once this is done I also strongly believe you will need more tip definition and projection; your current tip is a little rounded and lacks definition. Once the rib graft is shaven down or fixed the issue with the tip will become more prominent. I suggest you see a plastic surgeon who is experienced with revision cases as you will want this to be your final procedure to attain your desired results without further surgery.
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April 5, 2019
Answer: Revision Rhinoplasty / Rib Graft hi d_d, I have been performing revision rhinoplasty as a speciality of mine for over the past ten years and have seen this complication come into my office often from other surgeons quite often. You would never screw the graft in as it is warped. In my opinion the caudal (lower) aspect of the rib cartilage is warped upwards and needs to be shaved down. I believe this is an easy fix. But once this is done I also strongly believe you will need more tip definition and projection; your current tip is a little rounded and lacks definition. Once the rib graft is shaven down or fixed the issue with the tip will become more prominent. I suggest you see a plastic surgeon who is experienced with revision cases as you will want this to be your final procedure to attain your desired results without further surgery.
Helpful