Reusing Cartilage in Revision Rhinoplasty?

I had a rhinoplasty a year ago and my nose looks lumpy, and one side is indented giving the nose an off centered appearance. My doctor says the cartilage graft placed over the nose has shifted, with the lumpy area being the shifted cartilage. Im scheduled for a revision where he will remove the graft and put silicone on the indentation at the top side of nose. Im afraid of silicone; could the shifted cartilage be used to fill the indentation? Nose still too large so ok with reduction

Doctor Answers 10

Revision rhinoplasty

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I prefer to use the patients own tissues vs silicone.  Sometimes you can use the cartilage present in the nose if it is workable and reposition it.  Other times ear or rib cartilage may be used.  I prefer these over silicone any day.  Donald R. Nunn MD  Atlanta Plastic Surgeon.


Revision Rhinoplasty and Reusing Grafts

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Thank you for this great question. When grafts are used in rhinoplasty, they are typically secured with sutures. During the healing process, unpredictable things can happen and grafts can shift. Some surgeons will use silicone to "fill in" minor imperfections. There are benefits to this (non-surgical) but also some risks that you should discuss with your doctor. In either case, the cartilage that shifted should be able to be used in a revision procedure. Best of luck!

Silicone in the nose

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The cartilage used in initial rhinoplasty can be used again during revision rhinoplasty. In the worst case a new piece of cartilage can be obtained from the septum or the ear cartilages.

Silicone in the nose is controversial. Some surgeons love it, some hate it.

My preference is to never use Silicone.


Dr J

Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

Cartilage is a good graft choice in rhinoplasty

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Cartilage can be harvested from your nose and used in other areas of the nose. This is a great option since it is your own tissue and can be sculpted.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon

Reusing Cartilage Graft in Revision Rhinoplasty

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In 35 years I've avoided the use of silicone grafts because of the risks of infection, movement, and extrusion. I would use the previously placed cartilage graft; I always prefer the patient's own tissue.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Cartilage vs silicone

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I prefer to use cartilage over silicone grafts for nasal surgery. They do better and have less risk of getting infected.

Questions about revision rhinoplasty

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I prefer to use cartilage over silicone grafts.  These grafts can tend to be stiff and if they push up against the skin can cause skin erosions. If there is not enough cartilage available from the septum then the next choice would be ear cartilage.  There are several other factors that may be involved in your individual situation and of course a thorough examination is needed to determine the desired shape of the nose.  A secondary or revision rhinoplasty can be a very difficult operation due to altered structures and scarring.  Experience is key when selecting a plastic surgeon for this type of operation.     

Recycling Cartilage Grafts In Rhinoplasty

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When possible it is always better to recycle a cartilage graft in the nose. If it can't be used or is inadequate a new graft should be taken. There are numerous methods available to secure cartilage grafts so they do not shift after surgery.

Revision rhinoplasty and crooked nose

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Dear Tereseain FL,

  • The shifted cartilage can be moved during revision rhinoplasty
  • Your surgeon is probably concerned that since the graft already moved once, there is a chance it can move again
  • Liquid silicone is a very nice alternative where you can add volume exactly where you want it without worrying about cartilage moving
  • The amount of silicone used is very minimal, usually about 0.1cc which equates to about 1/50th of a teaspoon

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Reusing Cartilage Graft in Revision Rhinoplasty

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   Although at face value, this seems like a perfectly good idea, there may some reason why the surgeon is reluctant to do this.  If the cartilage graft is compromising the skin in any way, there may be a concern for further compromise for a graft in that area.  Hard to say.  In general, I do not use foreign material in the nose and prefer native cartilage.  Kenneth Hughes, MD Los Angeles, CA

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.