The dorsal onlay graft (ear cartilage) that I have is slanted and too thick. Do I need a full rhinoplasty to correct it or can it be reshaped/repositioned in a closed rhinoplasty?
Answer: Shifted cartilage Thank you for your question. Revision rhinoplasty of any kind is a challenging surgery and should really only be done at the hands of a double board certified Facial Plastic Surgeon. This is very important as there are those that call themselves board certified Plastic Surgeons and have very little experience in the nose, especially with revision nasal cases. Having said that, grafts can shift especially if not crushed or secured to the nasal skeleton. If you have thin skin, the graft can become more visible, so this becomes more important.I hope that this helps and again the most important part is seeking the advice of a specialist in this field.
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Answer: Shifted cartilage Thank you for your question. Revision rhinoplasty of any kind is a challenging surgery and should really only be done at the hands of a double board certified Facial Plastic Surgeon. This is very important as there are those that call themselves board certified Plastic Surgeons and have very little experience in the nose, especially with revision nasal cases. Having said that, grafts can shift especially if not crushed or secured to the nasal skeleton. If you have thin skin, the graft can become more visible, so this becomes more important.I hope that this helps and again the most important part is seeking the advice of a specialist in this field.
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May 4, 2018
Answer: Revision rhinoplasty Hello and thank you for your question. The best advice you can receive is from an in-person consultation. For a revision rhinoplasty such as this, I highly recommend an open approach. For dorsal augmentation, I often use diced cartilage wrapped in fascia, which will not have the same risk of malposition as a simple cartilage onlay graft. This decision should be based on a detailed discussion with equal input from both you and your surgeon. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person. Best wishes and good luck. Richard G. Reish, M.D. FACS Harvard-trained plastic surgeon
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May 4, 2018
Answer: Revision rhinoplasty Hello and thank you for your question. The best advice you can receive is from an in-person consultation. For a revision rhinoplasty such as this, I highly recommend an open approach. For dorsal augmentation, I often use diced cartilage wrapped in fascia, which will not have the same risk of malposition as a simple cartilage onlay graft. This decision should be based on a detailed discussion with equal input from both you and your surgeon. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person. Best wishes and good luck. Richard G. Reish, M.D. FACS Harvard-trained plastic surgeon
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May 3, 2018
Answer: Closed rhinoplasty Thank you for your post. Yes, dorsal cartilage graft can be reshaped and repositioned using closed rhinoplasty techniques. Be sure your surgeon is one who is experienced in this approach. Good luck.
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May 3, 2018
Answer: Closed rhinoplasty Thank you for your post. Yes, dorsal cartilage graft can be reshaped and repositioned using closed rhinoplasty techniques. Be sure your surgeon is one who is experienced in this approach. Good luck.
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May 3, 2018
Answer: Revision Rhinoplasty Your goals could be accomplished with either an open or closed rhinoplasty approach. I think there is way too much hype about each surgery because people use it for marketing purposes. The only real difference access wise on an open versus closed approach is the small incision at the base of the nose. In my opinion (and I am comfortable with both approaches), you should proceed with an open approach. An open approach gives much better exposure and control for a revision. Good luck.
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May 3, 2018
Answer: Revision Rhinoplasty Your goals could be accomplished with either an open or closed rhinoplasty approach. I think there is way too much hype about each surgery because people use it for marketing purposes. The only real difference access wise on an open versus closed approach is the small incision at the base of the nose. In my opinion (and I am comfortable with both approaches), you should proceed with an open approach. An open approach gives much better exposure and control for a revision. Good luck.
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Answer: Reshaping a doral onlay The dorsum can be approached with either an internal or external rhinoplasty for both primary and revision surgeries. Onlays can be removed, reshaped and replaced. There are times when the scar tissue will have filled in the area around the graft and a much smaller or no graft may be necessary at all. Surgeons tend to have comfort with open or closed techniques and some are proficient at both.
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Answer: Reshaping a doral onlay The dorsum can be approached with either an internal or external rhinoplasty for both primary and revision surgeries. Onlays can be removed, reshaped and replaced. There are times when the scar tissue will have filled in the area around the graft and a much smaller or no graft may be necessary at all. Surgeons tend to have comfort with open or closed techniques and some are proficient at both.
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