Is Rib Cartilage Rhinoplasty Reversable, and Still Have a Normal Looking Nose? How Soon?

I had a revision rhinoplasty 4 weeks ago. I had 3 rhinoplasty surgeries. My nose was O.K. after the first procedure. It was straight, I was wanted some narrowing. The second surgeon created a whole new nose that I did not ask for. He made my bridge crooked, zigzag. He cut my round tip made it a triangle shape and lifted it. One ear was used for cartilage grafting, very painful.The third surgeon said that I needed rib rhinoplasty.Now I have a stiff nose, pointy tip. Can I have all this removed?

Doctor Answers 4

Removal of Rib Cartilage after Revision Rhinoplasty

Rib cartilage can always be removed, but wait until you see your final result before considering another revision. Slow down and be clear about your goals and expectations if you decide to have more surgery.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Rib cartilage use in revision rhinoplasty

Great question... Stiffness of the tip is common after a rhinoplasty and particularly when it has only been 4 weeks since your surgery. As the swelling goes down, the nose should become less stiff. In some cases in which there is a loss of tip support during prior rhinoplasty surgery, making the tip more structurally sound and perhaps stiffer is a necessary tradeoff for a nose which looks and functions better.

This pointy shape and stiffness is not a reflection of the fact that rib cartilage was used. In my opinion, rib cartilage an excellent option for reconstructing the nose when there is insufficient strong, straight cartilage left in the septum. Rib cartilage can be carved or shaped into many different types of grafts. Ear cartilage is also used at times in revision rhinoplasty for contour issues and some types of grafts but, by nature, it tends to bend more easily than septum or rib. The choice of which type of cartilage to use ultimately comes down to the unique anatomical needs of the patient and the experience and preference of the surgeon. 

Your best bet at this stage in the process is to follow up closely with your surgeon and let him or her know the issues that are bothering you. Generally, the rule of thumb is to wait 9-12 months before revision nasal surgery though sometimes there are earlier interventions such as steroid injections which can reduce swelling in the nose a little quicker. Cartilage grafts can certainly be removed in the setting of another revision rhinoplasty but without examining your nose in person, I cannot advise you as to whether this would be a good idea. 

Best regards,

Dr. Mehta

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.6 out of 5 stars 48 reviews

Is Rib Cartilage Rhinoplasty Reversable, and Still Have a Normal Looking Nose? How Soon?

 You've had 3 Rhinoplasties so the healing time would be expected to be closer to a year and certainly 4 weeks is way too soon to be planning a 4th IMHO although I'm not a fan of rib cartilage for Rhinoplasty.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Rib cartilage rhinoplasty

You cannot remove the rib cartilage without the risk of collapsing the whole thing especially after three rhinoplasties.  You should leave this alone for a year, learn to adapt to your nose and plan no more revisions.  Go back to your doctor and stick close to them during the recovery.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

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