Adding Another Layer of Autologus Material After Revision Rhinoplasty?

I had my Rhinoplasty revision surgery 3 months ago to replace silicone implant with ear cartilage. My surgeon used my septal cartilage and ear cartilage to build my tip, and ear cartilage to augment my bridge. And the problem is, one side of my nostril is slanted while the other straight. And my nose does not look great at all with flat bridge and round nose tip. It was almost perfect to me at one month post op. It seems to me that my nose tip was shortened and more rounded during the healing (or even maybe reabsorption).

I want to add another layer of autologus material over my ear cartilage. Is it necessary to take out the ear cartilage and put it back again? I am afraid by the time when I do the revision surgery, the ear cartilage will already grow firmly with my nose bone and it will be traumatizing to my nose to seperate them by force.

Also, if I were to have a third surgery in future, will it be a danger that my nose is going to collapse? I heard that too many surgeries will make your nose weak and leading to collapse. Since my surgeon has already used my septal cartilage as a base to build my nose tip. Will my nose be prone to collapse? What will be the sign in terms of appearance when the nose is collapsing? Thank you.

Doctor Answers 7

Wait until nose is fully healed to decide

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As far as collapsing of the nose, this will not occur unless you sustain severe trauma to the nose. Collapsing of the nose will be most evident by a saddle nose deformity, which you obviously do not have at this point. This would show up immediately after the surgery if it were going to occur. I would not recommend removing and replacing any ear cartilage grafts unless they are causing severe problems in the nose because of the extent of revision rhinoplasty work that you have had done. Do not make any judgments on this nose until after one year of full healing, and then consult with your original surgeon.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

You might benefit from an Injectable Filler treatment.

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Revision rhinoplasty is one of the most challenging, and humbling operations I perform. It would be best if this surgery were your last, since your surgeon needed both ear, and septal cartilage after removing the silicone implant.

You can have injectable fillers safely placed in your nose to correct minor assymetries that are visible at 3 months after rhinoplasty.

I didn't get a clear picture of how your nose looks, or what's bothering you, so feel free to email me a full facial picture with a description, and I'll be happy to share my thoughts.

I've attached a link to my Non-Surgical Rhinoplasty page for your perusal.

I hope this helps, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Revision rhinoplasty takes time to assess

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You had revision rhinoplasty only three months ago so it is too early to assess the results. Most surgeons would wait a full year before considering re-operation. Operating before waiting that long makes no sense because it takes that long for the nose to fully heal, and sometimes longer. Complete healing means that the scar tissue has matured, the swelling has gone out of the nose, and the cartilage has been integrated into the tissues. Early on, the nose, especially the tip, often feels firm and stiff. Your physicin can determine when it has recovered enough to consider further improvement.

Daryl K. Hoffman, MD
San Jose Plastic Surgeon
4.6 out of 5 stars 17 reviews

Revision Rhinoplasty

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It is to soon to assess any results and you must wait at least a year for any revision rhinoplasty surgery. Be patient and discuss the many options of autologous materials available with your surgeon. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 218 reviews

Revision Rhinoplasty

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Hi Pumpkin,

You should wait at least one year before having further revision surgery on your nose. You can have more autologous grafting material (other ear cartilage, fascia, rib cartilage).

As long as your surgeon maintains adequate dorsal septal cartilage support, your nose should not be in danger of collapse. The main sign of nasal dorsal collapse is progressive lowering of the profile in the middle third of the nose.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Revision Rhinoplasty

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It's easy to say but BE PATIENT. The worse thing yo can do is to rush into another procedure before the results of the revision have been fully matured, that is the scar tissue internally and tissues have matured and the transplanted cartilages have been fully integrated. You definitely wil continue to see changes over the next 6-9 months. Only after the 9-12months post op period can a true assessment be made as to what needs to be done to improve your situation (if anything). There may be other soft tissues that can be used to augment the areas of concern without resorting to cartilages.

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon

Allow time for current grafts to take

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AS others have advised, I concur and beleive that you could cause more damage by intervening too soon.

Give it time for the current cartilage to take.

There are many different sources for autologous materals as mentioned: fascia, dermis, cartilage, etc.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 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.