How much septal cartilage is there in the average pre-op nose?

How big is the septum? I had a consultation for revision rhinoplasty and the surgeon said the amount of septum listed in my post op report does not appear correct. He poked around in my nose with a tool. The report says I have 2.5cm dorsal strut and 2cm caudal strut remaining, and a piece 3cm x 1.5cm was removed.

Doctor Answers 4

How much septal cartilage

There is about two quarters placed side by side. Not all of this is useful for revision about 1/2 of this must be left for support

Los Angeles Plastic Surgeon
4.7 out of 5 stars 30 reviews

Determining the Amount of Septal Cartilage Available for Rivision Rhinoplasty

A surgeon is concerned about the amount of cartilage present, the quality and thickness of that cartilage, and the integrity if the septum which may have been violated by previous surgery or nasal trauma; the septum provides the tent-pole support for the nasal structures.  I always discuss the possibility of harvesting ear cartilage with the patient before revision surgery because it is difficult to answer these questions pre-operatively. Previous operative reports can be helpful but are not always accurate.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

How much septal cartilage is in the nose?

This is a great question. And I wish I knew the answer.

As a rhinoplasty surgeon, I wish I could know how much septal cartilage was in someone's nose before surgery. It would make discussions about using cartilage from the or rib easier. Beyond the size, the quality of the cartilage is important. The thickness, whether it has cracks in it, and the stiffness of the cartilage are important too. The surgeon also needs to correlate the amount of cartilage present and the amount cartilage grafting that is necessary. 

Fortunately, the majority of primary cases have adequate cartilage in the nose. I like to discuss the backup options of harvesting cartilage from the ear or rib so there are no surprises for the patient. 

Victor Chung, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

How much septum do I" have left after primary rhinolpasty?

The determination of amount of remaining septum can be determined using the operative report and clinical exam, as you have had.  The secondary surgeon only has this information available.

Since the septum is a semi rigid structure it may be deduced upon palpation or movement the amount remaining.  This is not exact science.

The septum may have been used in your primary rhinoplasty or removed because of obstruction.

An excision of 3 cm X 1.5 cm amount should leave you enough support.  But it may not be easily accessible due to posterior placement and anatomy.

Additional cartilage can be found in your ribs or ear if necessary for another procedure.

Ernest Robinson, MD
Aliso Viejo Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

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.