Is it Difficult to Remove/Trim a Rhinoplasty Graft?

Question

I had revision rhino with rib grafts.. now i think my nose is too large... so would it be "Easy" to remove/trim the grafts? can it be done under local? or is it a difficult procedure to trim/remove to modify the nose and make it smaller? how complex is graft trimming/removal (rib grafts)

William Portuese, MD · Answer

Removing and trimming a rib graft through a tertiary rhinoplasty is no easy feat. It is extremely complicated and must be done under general anesthesia, not local anesthesia. Rib grafts tend to get tissue ingrowth making them difficult to remove, which is why it requires a major revision rhinoplasty.

Gregory Pippin, MD · Answer

It is difficult to make any suggestions without examining you or seeing photographsy.  I would recommend waiting a minimum of one year following you initial procedure for any revision.  Have you let your surgeon know about your concerns.  If you are not satisfied seek a second opinion.   Make appointments for consultations with multiple surgeons. Look at lots of before and after photos. Board certification by The American Board of Facial Plastic and Reconstructive Surgery, The American Board of Cosmetic Surgery, The American Board of Otolaryngology or The American Board of Plastic Surgery is preferred. Warmest regards.
	
		Dr. Pippin

Samir Shureih, MD · Answer

Revision Rhinoplastyis always more difficult than primary rhinoplasty.

	To trim a rib graft, depends on how long it has been since the graft,Is the graft mobile, or stuck to the bone?Complete removal will cause major deformity. Triming is possible. I prefer rhinoplasty under general anesthesia.

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

The reality is that Revision Rhinoplasty is always more complicated and difficult than a primary one because of tissue scarring and disruption from the previous surgery(s). Aesthetically speaking, I don't use rib cartilage/bone for building up the nasal bridge as it has a tendency to dissolve unevenly over the years IMO. The graft can be shaped or better still replaced with a reliable, straight silastic dorsal implant however, the exposure...or getting to the implant will require another full Rhinoplasty. Be sure that the Revision Rhinoplasty Surgeon, you choose, understands and follows the proper aesthetics of facial (and nasal) beauty for the creation of a naturally more attractive nose.

Richard W. Fleming, MD (retired) · Answer

Your rib graft can be revised, but it would be best to do this with at least some sedation in addition to the local anesthesia.

Is it Difficult to Remove/Trim a Rhinoplasty Graft?

Answers (5)