Is Any of the Perichondrium Removed During Rhinoplasty Surgery?

I know the nasal perichondrium keeps the cartilage healthy, do surgeons remove any of this during rhinoplasty surgery or is it always kept intact? Will I know if it has been removed? Thank you

Doctor Answers 7

Perichondrium not removed during rhinoplasty

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The perichondrium is left intact during a rhinoplasty procedure and is not removed.  It is peeled off of the lower lateral cartilages, upper lateral cartilages and septum during a septoplasty and/or rhinoplasty procedure.  It is important to leave it in place during the procedure.

Perichondrium Removed During Rhinoplasty

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Perichondrium does nourish the cartilage but the success of rhinoplasty surgery does not  depend on the amount of perichondrium interrupted or lost.

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

Is Any of the Perichondrium Removed During Rhinoplasty Surgery?

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That seems a rather specific and odd question to ask regarding Rhinoplasty.  That layer is typically preserved by lifting it up, exposing and trimming the cartilage.

Perichondrial Manipulations in Rhinoplasty

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The perichondrium is most certainly manipulated in a rhinoplasty, either being cut, scraped and even elevated off of the cartilage. While some perichondrium may be removed from certain cartiaginous areas, it is not done so to leave the cartilage deliberateliy denuded. Regardless, such perichondrial alterations do not affect the health of the nasal cartilages and will in now way adversely affect your rhinoplasty result. 


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I do not know why this would be a concern. If I place a cartilage graft carved out of rib it does not have a perichondrium. If I come back later to look at it I will see the body has covered it with a layer of perichondrium.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Perichodrium is not removed during surgery.

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The perichodrium is the covering right against the cartilage.  It is thin and provides nourishment to the cartilage.  For your surgeon to shape the nasal cartilage correctly, the perichodrium is gently lifted off the cartilage but is replaced afterward so it can continue its function.  None is removed.

Perichondrium and Nose Surgery

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The pericondrium holds and nourishes the cartilage. Depending on what is done ( refining the tip vs straightening the septum) the perichondrium may have to be lifted to allow cartilage modification after which it is placed back. I'm not sure why you should concern yourself with the minute technicalities of nose surgery. Pick a good nose surgeon and lt him worry about the details on how to achieve your cosmetic goals. 

Peter A. Aldea, MD
Memphis Plastic Surgeon

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.