I have a collapsed nasal valves,scooped bridge,and upturnrd tip from a primary rhino.I went on 2 consults for revision. One Dr suggested using ear cartilage to fix the scoop. Another suggested using irradiated donor cartilage that is ground up to a paste and temporal facia. Which method is favored and why?
October 28, 2014
Answer: Revision Rhinoplasty
Using ear cartilage or rib may be equally effective in correcting your nasal concerns. Different surgeons have different preferences regarding their choice of donor material. Some surgeons would argue that using your own rib is better than cadaver rib as well. The important question is how much cartilage is needed and is ear going to provide enough grafting material as well as how experienced your surgeon is in performing a complicated revision procedure.
Helpful
October 28, 2014
Answer: Revision Rhinoplasty
Using ear cartilage or rib may be equally effective in correcting your nasal concerns. Different surgeons have different preferences regarding their choice of donor material. Some surgeons would argue that using your own rib is better than cadaver rib as well. The important question is how much cartilage is needed and is ear going to provide enough grafting material as well as how experienced your surgeon is in performing a complicated revision procedure.
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April 7, 2018
Answer: "Best" Option for Augmenting the Nose is Diced Cartilage Wrapped in Fascia
What is the "Best" option for augmenting the nose?
You will not get agreement amongst surgeons to this question! With that caveat out of the way, I'll give you the opinion that I've held for more than 5 years: Diced Cartilage (your own cartilage) Wrapped in Fascia (your own fascia) is "the best" tissue or material available when a significant augmentation of the back of the nose is needed.
Advantages of Diced-Cartilage Grafts Wrapped in Fascia:
It becomes completely integrated into your body, therefore it will not have a risk of becoming encapsulated or infected in the future like an implant can.
When your own cartilage and fascia are used (instead of cadaver tissue), the chances of resorption of the tissue is the very lowest.
Because the cartilage is diced into tiny pieces and wrapped in a soft wrapper of fascia, it is the least likely graft to have it's edges become visible through the skin over time as our tissue age and our skin thins.
This graft technique is "mold-able" to a small degree even at one week after surgery, where minor adjustments can simply molded through the skin and your splint can then be replaced to protect the nose during healing for the 2nd week.
Some Disadvantages:
Probably the biggest disadvantage is time. It takes time to harvest fascia using a small incision behind the ear and time harvest and prepare the cartilage (which can come from either the nose, ear or rib).
It is not rigid enough for cases where a very large augmentation of the nose is needed.
Hope this helps!
Nick Slenkovich, MD FACS
Helpful 6 people found this helpful
April 7, 2018
Answer: "Best" Option for Augmenting the Nose is Diced Cartilage Wrapped in Fascia
What is the "Best" option for augmenting the nose?
You will not get agreement amongst surgeons to this question! With that caveat out of the way, I'll give you the opinion that I've held for more than 5 years: Diced Cartilage (your own cartilage) Wrapped in Fascia (your own fascia) is "the best" tissue or material available when a significant augmentation of the back of the nose is needed.
Advantages of Diced-Cartilage Grafts Wrapped in Fascia:
It becomes completely integrated into your body, therefore it will not have a risk of becoming encapsulated or infected in the future like an implant can.
When your own cartilage and fascia are used (instead of cadaver tissue), the chances of resorption of the tissue is the very lowest.
Because the cartilage is diced into tiny pieces and wrapped in a soft wrapper of fascia, it is the least likely graft to have it's edges become visible through the skin over time as our tissue age and our skin thins.
This graft technique is "mold-able" to a small degree even at one week after surgery, where minor adjustments can simply molded through the skin and your splint can then be replaced to protect the nose during healing for the 2nd week.
Some Disadvantages:
Probably the biggest disadvantage is time. It takes time to harvest fascia using a small incision behind the ear and time harvest and prepare the cartilage (which can come from either the nose, ear or rib).
It is not rigid enough for cases where a very large augmentation of the nose is needed.
Hope this helps!
Nick Slenkovich, MD FACS
Helpful 6 people found this helpful