Removing Cartilage Graft from the Tip of the Nose to Make It 1 to 2mm Shorter

Question

Tip of my nose looks much higher and upward due to the graft. I want to have a straight nose, but my doctor convinced me that rotating the tip will look good. I hate the look of my nose. The graft looks so unnatural. I want to make the tip of my nose 1 to 2mm shorter by removing the graft. Is it possible to do this without affecting the rest of the nose. Thanks

Philip Solomon, MD, FRCS · Answer

In short yes the graft can be removed and in some cases it can be done with local anesthesia.In certain cases the tip graft can be  crushed  and replaced to give a softer less visible appearance.  Best to speak to your surgeon and come up with a plan.  photos would be helpful.

Sam Naficy, MD, FACS · Answer

ideally you should wait at least 6 months to see how the tip projection changes - what may look overly projected at 2-3 weeks may look great after a few months

David C. Mabrie, MD · Answer

Revision Rhinoplasty can be very challenging.  There are several details needed to answer your question.  Most importantly a photograph would be very helpful. Altering the tip graft will certainly change the appearance of your nose.  Unless you've lost complete trust in your initial surgeon, he or she may be in the best position to perform the revision.  If you are able to articulate your concerns you may be able to form a plan together.

	If you are not able to work with your current surgeon, you will need to start the process of finding someone else who is experienced with revision rhinoplasty to help your contour your nose. 

	Don't make your decision hastily.  Just because the first surgery wasn't completely successful doesn't mean your current surgeon can't help you.  Sometimes, a small secondary surgery can be helpful.

	Good luck in your search for answers!

Mark B. Constantian, MD, FACS (retired) · Answer

Tip grafts must be suited to the skin type and to the effect that the patient wants.  Single, solid grafts are used often and can make the tip look too pointed and "hard."  Sometime tip grafts are too long. 

	These grafts can be revised by removing them and re-using the same cartilage or taking new cartilage.  If the grafts are too stiff, they can be crushed so that they become some and very natural-looking.

	It is important that you find a surgeon experienced in these revisions whom you trust and whose tip graft results you like.

Francis R. Palmer, III, MD (retired) · Answer

This is very hard to make any decision without seeing picture of the nasal tip from front and side views. I'd have to see if the nasal tip is over rotated or over projected which are handled differently.

Removing Cartilage Graft from the Tip of the Nose to Make It 1 to 2mm Shorter

Answers (5)