Is the visibility of the overlaid cartilage in revision rhinoplasty permanent or just swelling?

My first rhinoplasty left a hard bump on the right lateral side of the bridge of my nose and a depression underneath the bump. To fix it the surgeon shaved down the bump and did a cartilage overlay which he got from the tip of my nose. I had the revision 10 days ago and got the cast off 4 days ago. Two days after cast removal the rectangle of the cartilage is noticeably laid diagonally across my entire nose-2cmx3cm. As the swelling goes down it's more visible. Is this permanent or swelling?

Doctor Answers 4

Cartilage graft visibility-revision rhinoplasty

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Thanks for your question. It is hard to answer your question without photos. You are still early and would be best advised to wait for the swelling to go down. 
Best wishes,
Dr Sajjadian

Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Cartilage grafts in revision rhinoplasty

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Without seeing your photos it is a litte difficult to answser your question absolutely precisely but I will do my best.  It sounds like you probably have fairly thin skin of the nasal dorsum.  Cartilage onlay grafts in any individual with thin skin are difficult to camouflage.  It sounds like your surgeon had the right idea but if the graft edges are visible after just a couple of weeks, you are likely going to require some minor revisions to the graft as they will become more identifiable as the swelling subsides.  In thin skin individuals I tend to wrap the graft in temporalis fascia if I am unable to bevel the edges of the graft so that they flow smoothly into the surrounding nasal tissue.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Swelling after revision rhinoplasty

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Dear anon1985,

  • At this point, it is difficult to be certain
  • It can still be swelling and I would bring this up to your surgeon
  • It also depends on your examination
  • When you press down on it, does the skin flatten at all?  If it does flatten a little, then it is swelling

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Cartilage graft and visibility

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Some cartilage grafts are more noticeable than others. Without seeing yours in a photo or in person I can not say. Only time will tell at this point.

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

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