How do septal grafts affect the septum?

Question

I've heard that many surgeons prefer using septal cartilage when performing tip refinement and projection. As an Asian patient, I am interested in projecting my tip a little bit, and the doctors I have consulted with have mentioned septal grafts. However, will removing septal cartilage destabilize the septum? What will be the long-term effects of this, and could the nose possibly collapse because of the removed cartilage?

Donald B. Yoo, MD, FACS · Answer

You bring up an extremely astute question. Textbooks and training will teach rhinoplasty surgeons to maintain 10-15 mm of septal cartilage to preserve the strength of the septum, but clearly this does not take into account the anatomic variation that exists with Asian noses as the septum is often thinner and weaker than a standard white patient's nose.

The septum, and the dorsum of the nose can indeed collapse and create a "saddle nose" deformity if the structural integrity of the septum is not preserved. It's important to seek out a surgeon experienced and skilled in Asian rhinoplasty to avoid these easily preventable issues.

Andrew Miller, MD · Answer

As long as the septal cartilage is removed while leaving a strong strut in place, the septum will be fine. Be sure to see a rhinoplasty expert for consultation.

Jeffrey H. Spiegel, MD · Answer

Asian patients with low nasal projection typically will have weak and minimal septal cartilage. If "harvested" correctly it won't affect the stability of your nose, but, it may also not be enough to do what is needed. There are typically better options for Asian persons, and we will use these other techniques.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. It is extremely safe to harvest septal cartilage when good technique is used. A portion called the L strut is always left behind as structural stabilization. This is very commonly performed in rhinoplasty surgery. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

How do septal grafts affect the septum?

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