Is it Normal for Perform a Skin Graft During a Septorhinoplasty?

So After meeting up with my surgeon and going over the plan for the surgery. It has been agreed that he would fix my cleft lip revision and my nose. During this conversation, he spoke about removing skin to over layer the nose as skin is thin.. Of course this surprised me as i have not heard it before. I would be grateful if someone could explain the whole removing skin to over layer the nose and where the skin is removed from? thank you. Mariana

Doctor Answers 3

Cleft lip rhinoplasty and potential grafts

Dear Mariana

Please clarify this with your surgeon, but "over layer the nose" seems to be consistent with a Rhinoplasty technique that we use  in patients with  thin skin.   Usually, either temporalis fascia from above or behind your ear can be removed from UNDER the skin, and grafted onto the nose, under the skin.  Other grafts are also possible for this purpose.  I suggest researching what you learn in these posts, then schedule another consult to clarify with your surgeon. Best Wishes

Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Hmm maybe alloderm

Sounds like you may be misunderstanding your surgeon. Please go back and make sure you are clear on the plan. My GUESS is that the surgeon was considering using alloderm, human acellular dermis, to act as a cushion layer between the skin and the cartilage layers. Skin grafting would be very unusual in a case like this. Good luck!

J. Charles Finn, MD
Raleigh-Durham Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

During rhinoplasty , external skin grafting is unusual.

Perhaps some confusion is at work here. 

It is very unusual to place a skin graft on the outside of the nose during a rhinoplasty, even if it is to correct a cleft lip and nose.

Perhaps the skin graft is intended to be placed on the inside of the nose, but you must be very clear on what the doctor’s intention is.

The negative thing about skin grafting on the outside of the nose:

•   It is very hard for the skin graft to perfectly blend in with the surrounding tissue.

For that reason, while skin grafts on the inside of the nose are perfectly legitimate -- and practical -- because they are invisible, the outside of the nose presents a different story during rhinoplasty.

Good luck!

Robert Kotler, MD, FACS
Facial Plastic Surgeon



Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 86 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.