I need a revision. I've had two doctors say based off primary op reports as well as a cone 3D scan that they believe I have septal cartilage. Two others feel I will need rib. Is there anyway to get the best answer about this? I would rather use septal so I don't want to just go use rib just because I picked a great doctor who likes rib. What is the best way to determine this? I know this is no for sure answer but it is hard to believe that with all technology we have we can't get a better idea.
Answer: Revision rhinoplasty grafting choices The best choice for grafting material is always the septum if that tissue is available in sufficient quantities. Ear or conchal cartilage is the second best choice and the last choice is rib cartilage, either from you or from cadaver rib. If you need a lot of cartilage grafting the rib maybe necessary especially if you need to replace a large amount of nasal dorsum or top of the nose for correcting deficiencies. That being said if you have sufficient septal cartilage, I would recommend that route as the primary choice. You can always do cadaveric rib cartilage as a second choice to avoid an incision in the chest. Good luck with your surgery.
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Answer: Revision rhinoplasty grafting choices The best choice for grafting material is always the septum if that tissue is available in sufficient quantities. Ear or conchal cartilage is the second best choice and the last choice is rib cartilage, either from you or from cadaver rib. If you need a lot of cartilage grafting the rib maybe necessary especially if you need to replace a large amount of nasal dorsum or top of the nose for correcting deficiencies. That being said if you have sufficient septal cartilage, I would recommend that route as the primary choice. You can always do cadaveric rib cartilage as a second choice to avoid an incision in the chest. Good luck with your surgery.
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March 25, 2020
Answer: Is there enough septal cartilage for revision rhinoplasty? Many surgeons prefer to go strait to rib cartilage to have an abundance and impart it is because there is variance on many grafts people use. In general unless there is need to substantially augment the dorsum ( such as in over resected dorsal profile or saddle nose, in my hands septal cartilage is almost always sufficient, even if a septoplasty was previously done. It is important to look at before and after pictures and an in person examination and analysis is necessary.
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March 25, 2020
Answer: Is there enough septal cartilage for revision rhinoplasty? Many surgeons prefer to go strait to rib cartilage to have an abundance and impart it is because there is variance on many grafts people use. In general unless there is need to substantially augment the dorsum ( such as in over resected dorsal profile or saddle nose, in my hands septal cartilage is almost always sufficient, even if a septoplasty was previously done. It is important to look at before and after pictures and an in person examination and analysis is necessary.
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March 25, 2020
Answer: Is there enough septal cartilage for a rhinoplasty revision? Without posted photos, benefit of physical exam, reading the op-report and reviewing pre-op photos, it's difficult to give the best answer. In our Practice we perform multiple revision surgeries-through closed technique, and in certain cases we utilize rib cartilage grafts. I suggest that you seek an experienced Rhinoplasty Surgeon with a wide gallery of before and after photos
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March 25, 2020
Answer: Is there enough septal cartilage for a rhinoplasty revision? Without posted photos, benefit of physical exam, reading the op-report and reviewing pre-op photos, it's difficult to give the best answer. In our Practice we perform multiple revision surgeries-through closed technique, and in certain cases we utilize rib cartilage grafts. I suggest that you seek an experienced Rhinoplasty Surgeon with a wide gallery of before and after photos
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March 25, 2020
Answer: Cartilage source for revision rhinoplasty Hi, and thanks for your question. It's a really great question and something with which nearly every revision rhinoplasty patient is concerned. Generally speaking, you can get a good idea about how much septal cartilage remains during the in-person physical exam. I shine light through the septum, and use a small Q-tip to feel along it for resistance. If it feels floppy then we know there is minimal cartilage there. Unfortunately, imaging studies like CT scan, etc aren't very useful for showing this area well. If we can't be sure on the physical exam, then we would expose the septum during surgery and proceed to rib cartilage only if there is clearly deficient septal cartilage. The other option is ear cartilage, which is really nice for reconstructing the tip of the nose. My recommendation is to have an honest conversation with a surgeon with whom you connect. Everyone's preference is always to use septum if it's there. Rib or ear would be only as necessary. Hope this helps. Good luck!
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March 25, 2020
Answer: Cartilage source for revision rhinoplasty Hi, and thanks for your question. It's a really great question and something with which nearly every revision rhinoplasty patient is concerned. Generally speaking, you can get a good idea about how much septal cartilage remains during the in-person physical exam. I shine light through the septum, and use a small Q-tip to feel along it for resistance. If it feels floppy then we know there is minimal cartilage there. Unfortunately, imaging studies like CT scan, etc aren't very useful for showing this area well. If we can't be sure on the physical exam, then we would expose the septum during surgery and proceed to rib cartilage only if there is clearly deficient septal cartilage. The other option is ear cartilage, which is really nice for reconstructing the tip of the nose. My recommendation is to have an honest conversation with a surgeon with whom you connect. Everyone's preference is always to use septum if it's there. Rib or ear would be only as necessary. Hope this helps. Good luck!
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March 25, 2020
Answer: Preoperative consultation It would really depend on the amount of cartilage required and areas of the nose that need cartilage. Yes, generally having rib cartilage may be firmer when used as a 'large' piece that is shaped, however there are other techniques that utilize rib cartilage in very small pieces. Ear and septal cartilage are usually available, however, and I would ask about these details with your surgeon...
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March 25, 2020
Answer: Preoperative consultation It would really depend on the amount of cartilage required and areas of the nose that need cartilage. Yes, generally having rib cartilage may be firmer when used as a 'large' piece that is shaped, however there are other techniques that utilize rib cartilage in very small pieces. Ear and septal cartilage are usually available, however, and I would ask about these details with your surgeon...
Helpful 1 person found this helpful
