The Rib Cartilage Graft on Nose Bridge is Not in the Center. Can It Be Fixed?

Hello, I have a question about my recent rhinoplasty. About 7 months ago, I had an augmentation rhinoplasty with a rib cartilage graft and I have noticed that the bridge is a little more to the left side. I was wondering if the graft can be placed in the center. If so, how invasive would the procedure be? I don't feel like having another "big" surgery with all the swelling (specially with rib grafts) Thank you

Doctor Answers 6

Rib Graft Displacement After Rhinoplasty

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Dear Natel,


Without photos and physical examination, it is difficult to assess the asymmetry you are describing.


Nonetheless, rib cartilage grafts require extreme delicacy and expertise when to be carved to fit the patient's nose. 

At 7 months post op, absorption may not be an option that could cause bold asymmetries.

Also, you may be having some swelling left.


Fillers could be used to correct the asymmetry if the warping is not large otherwise, retrieval and re-grafting may be necessary as a revision.


Best of luck to you.

Dr. Sajjadian

Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Rib graft off center.

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It may be possible to do a minor procedure or a temporary filler.  Rib grafts can partially absorb or curve further with time.  This is why I have not had to use them in 35 years of rhinoplasty. You can achieve good results without resorting to ribs except in the most severe bridge loss. See an experienced revision rhinoplasty surgeon to discuss the pros and cons of different ways to fix your problem   

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Revision Rhinoplasty to Correct a Deviated Dorsal Cartilage Graft

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Thanks for the question. I would have to examine you in person to determine the size and extent of deviation of your rib cartilage graft. A copy of your previous operative report would also be helpful. Generally, the graft can be removed, shaved if needed, and replaced in a pretty straightforward procedure. It would likely be possible to do this through a closed, or endonasal approach, if there are no other issues with your nose. In any case, i wouldn't expect the same degree of swelling and recovery time that you had following your initial procedure, assuming the graft is the only factor needing correction. 


Dr. Mehta

Umang Mehta, MD
Bay Area Facial Plastic Surgeon
4.7 out of 5 stars 51 reviews

The Rib Cartilage Graft on Nose Bridge is Not in the Center. Can It Be Fixed?

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 The rib cartilage dorsal graft may not be off the midline but could be dissolving unevenly which they can do.  I'd have to see and feel the graft to see what's going on with the graft in order to make further recommendations.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Rib cartilage graft

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RIb cartilage can warp and this may be the problem. If it is off center, and you want it centered, the graft may have to be removed repositioned or even replaced.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revising a Rib Cartiage Graft

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It all depends on how off center the graft is. If it is slight you can try to correct it with injectable fillers. If its not amenable to fillers you may need to have the graft removed and repositioned and/or replaced. Rib cartilage tends to warp that's one of the reasons custom carved silastic implants are better.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 283 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.