Columella graft causing pressure and pain. Can this be graft be removed as soon as possible?

Question

I had a rhinoplasty procedure 1. 5 months ago. I had my procedure done overseas so I don't have access to my surgeon and am desperate for some help. A very large graft was placed in my columella, not only does it look too big and make me look like I have big nostrils, the graft seems to come down quite far and I am feeling constant pressure in my upper gums and it causes upper tooth pain. Can this graft be removed by a local surgeon as soon as possible or do I have to wait?

Ali Sajjadian, MD, FACS · Answer

Thanks Nr06 for your question! It is understandable that you're worried about the graft's size and location in addition to the discomfort you're feeling. A number of variables, such as the type of graft, the healing process, and the particular issues you're facing, affect when to have it removed.Usually  it is not recommented to rush back to operating room shortly after surgery. A local surgeon may be able to remove a graft, but it's important to make sure they have the training and experience required for rhinoplasty revision surgery. A board-certified plastic surgeon with expertise in rhinoplasty should be consulted due to the intricacy of the procedure and the possible dangers associated with graft removal. They are able to analyze the graft, establish the best course of action, and appraise your particular condition.
The following are important factors to consider while removing grafts:
-Healing Time: It's critical to give the initial healing process enough time to finish. Complications may arise if a transplant is removed too quickly.
-Graft Type: The healing period and the hazards of removal can be influenced by the kind of graft that is utilized, such as bone or cartilage.
-Surgical Skill: A competent surgeon can remove the graft with care and with the least amount of harm to the surrounding tissues.
-Post-Operative Care: To promote the best possible recovery and reduce problems, proper post-operative care is crucial.
Please note that it takes at least 1 to 1.5 year to see the final result of a rhinoplasty procedure. Removing graft too early can increase the risk of infection,scarring and structural compromise but If you're in a lot of pain or are worried about how the graft will look, it's important to talk to a Board Certified Plastic Surgeon about these concerns.
Hope this was helpful!
Best wishes,
Dr Ali Sajjadian 
TRIPLE Board Certified Plastic Surgeon

Eric M. Joseph, MD · Answer

Generally, when we put in Cali Miller strut crafts, these are to add structural support to your nasal tip. Occasionally they can cause clicking, however, they rarely cause pain. Do you feel a piece of cartilage underneath your upper lip in the midline? If your columella strut graft is displaced, sometimes these can be trimmed in the office with an incision inside your upper lip with minimal inconvenience. I hope this is helpful. Sincerely, Dr Joseph

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.If the graft is causing you pain and discomfort, I recommend you to go back to your surgeon and get it removed. If you can't do that, you have to go to a different ENT surgeon to get it removed. Possibility to remove it locally or not depends on your case. You will have an answer after the consultation.
Best regards!

Huseyin Balikci, MD · Answer

Hello dear patient, as a professional I advice you to wait until 1 year last. Your columellar graft will be softer for sure. You may not need revision. If you need revision, of course it is an easy procedure.

Abdulkadir Goksel, MD · Answer

I recommend that you be examined by a nose surgeon in your area. Generally, since these types of grafts may have carrier properties, they may cause deformity and loss of support in the nose when removed.

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