Nasal rib cartilage removal. Do I need a revision? (Photo)

Question

Dear doctors, I had a revision rhinoplasty a couple years ago and the doctor used rib cartilage in my nose. It was put in solid and not diced and as expected based on my research it warped. I like my nose minus the graft . I was wondering if I can just get the graft removed only or do I need a revision? Thanks for your feedback.

Tanveer Janjua, MD · Answer

It is possible to remove just the graft without a full revision. However, a lot of times the rib has fused with the nasal bones and soft tissue and it might be difficult to remove. It is best not to do any other implants etc at the same time. Let the nose heal for at least 3 months and then evaluate.
Regards
Dr. J

Donald B. Yoo, MD, FACS · Answer

Hi tyty42

The en bloc rib cartilage that was used to augment the bridge of  your nose can certainly be removed, but that may also affect the balance of your nose when the height that it provides to the bridge of your nose is taken away. An experienced rhinoplasty surgeon would be able to advise you of the option of simply removing the dorsal onlay (en bloc rib) vs. removing the dorsal onlay and replacing it with a graft that is straighter and more symmetric (diced cartilage fascia being one possibility).

Stephen J. Pincus, MD · Answer

It is possible to remove the rib graft, but it may cause some other changes in so doing, such as loss of tip support. You should speak to several revision rhinoplasty surgeons to get their thoughts and decide if you would allow them to go forward with other procedures if necessary.

Ronald J. Edelson, MD · Answer

The graft is too large. It can either be removed entirely or the graft can be shaved down so it it not so prominent

Eric M. Joseph, MD · Answer

Generally, it is difficult to evaluate people's noses with one photo. You appear to have a concavity along the left side wall of your nose. Perhaps this is where your bone graft became resorbed. Depending on your examination, microdroplet Silikon-1000 injections may be considered for adding volume to the concavity along your left side wall for a straighter and less distracting nasal appearance. I hope this is helpful! Sincerely, Dr Joseph

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