Third Revision with Alloderm or Conchal Grafts and Fascia? (photo)

I had a revision rhinoplasty 2 years ago. I have very thin skin and the tip was left looking even more pinched than the original. The surgeons suggested fixing it by placing alloderm in the tip. Another doctor had suggested using conchal cartilage to widen tip. Also one said to insert grafts to open nostrils and others said not to. It would be very helpful to hear what others think the best way to proceed would be.

Doctor Answers 1

Use Both Alloderm and Conchal Graft in Rhinoplasty Revision

Although your photos are limited, I see that there is irregular contour of your tip cartilages.   You have deficient cartilage at the tip.  In addition, the soft triangle of your nose, the area just lateral to the tip, appears to be contracted. To gain better contour of your tip and to support your thin skin, I recommend Conchal Cartilage Graft in combination with soft tissue augmentation.  Soft Tissue augmentation will act as a padding between the skin and the cartilage graft.  The Dermal Fat graft  or Alloderm may be used to augment the soft tissue. To correct the soft triangle constriction, Dermal-Conchal Cartilage graft inside the nose should be considered.  Dermal-Conchal graft is where the ear cartilage is taken along with the overlying skin as a one piece.  Be sure to consult with a Board Certified Plastic Surgeon.  Explanation of the nasal anatomy will help you understand the above.  The more information you gain, the more satisfied you will be.  Best Wishes!

Fairfax Plastic Surgeon
5.0 out of 5 stars 1 review

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