Revision Rhinoplasty with Ear Graft - Survival and Healing

Question

I recently underwent a 3rd surgery to remove a poorly placed and infected medpor implant. The doctor did use ear grafts to replace damaged tissue from the implant(which was only there 1 year). My question is - there is still significant swelling and it has been 4 months. How will I know if the ear graft did not survive and will my nose continue to decrease in size and improve my side profile -- which is bigger? I really can not go through another surgery with fear of circulation problems. :)

Thomas A. Lamperti, MD · Answer

Yes, being your third rhinoplasty, at 4 months from surgery you should have a significant amount of swelling. This is especially the case if there was an infected implant that had to be removed. It will likely take over 12 months for the final result to be evident, probably more in a revision case like your own.

	In my experience your own ear cartilage should do very well. It is pretty rare to see ths type of graft reabsorb.

Russell Kridel, MD · Answer

In looking at your nose pictures, the nose does not look overly swollen for this stage in your post op period. Your surgeon has probably told you that it will take at least a year for the majority of the swelling to go away. Remember that a cartilage graft taken from someplace else has to be integrated into the nose; this is a biologic process which takes time. I have followed noses for 10 and 20+ years post op and have seen changes in the nose post surgery take years to finally mature. Remember that you had surgery so your nose would look good for the rest of your life; if it looks too good too soon, what will happen later when more swelling goes down? Will it look under-corrected? Try to be patient and continue your follow up with your surgeon.

Michael L. Schwartz, MD · Answer

You are still very swollen. your own cartlage should survive well. You or your surgeon may be able to feel the graft.. For some patients after multiple revisions it can take 24 months to see yhe final result.

Samir Shureih, MD · Answer

Since you had an infected Medpore graft replaced with ear cartillage, you will be swallen for a long long time, may be 2 years. ifection, plus 3 surgeries, is enough to give you significant swelling. As for graft take, if your graft, cartillage gets infected or disappears with time you will know it did not take.

Richard W. Fleming, MD (retired) · Answer

I would expect persistent swelling 4 months after your second revision rhinoplasty with cartilage grafts. It may take another 12-18 months to see your final result.

Jay M. Pensler, MD - Account Suspended · Answer

It will take minimal 6 months more likely 12 -18 months to fully appreciate the result. Revision rhnoplasty is a very complicated surgery.

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

The swelling and size, of the nose, at 4 months post Revision Rhinolasty is not what you can expect at 12 months.  However, it's always best to ask, your Rhinoplasty surgeon, these types of questions.

Revision Rhinoplasty with Ear Graft - Survival and Healing

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