Septal extension graft removal vs. trimming to desired length?

In general grafts can be removed, modified or trimmed. It would be important to evaluate you in person to see the area of concern. Sometimes a surgical simulation tool using Vectra technology can facilitate communication.

In general, a septal extension graft can be trimmed or repositioned. It does depend how long is the interval between primary operation and revision. Over time, some cartilage grafts become softer and may no longer be suitable for a simple trimming.
As a rule of thumb, if the tip feels firm and on a computer simulation for the changes it appears that the amount of  reduction is small, trimming tends to work well.
If your ear cartilage was used in the tip, it may also be a graft placed over the septal extension graft. It may only be necessary remove this shield graft to achieve the shortening or the reduction in projection.
Discuss your concerns with your surgeon who will have information about the technique used and can guide you better.

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation. It would also be helpful to view pictures of your nose.  It may be possible to trim the extension graft or remove and replace.  The best option really depends on your nasal anatomy.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  You should be able to view numerous pictures of actual patients with noses similar to yours performed by your surgeon.  If you cannot find enough real before and after pictures, then consider continuing your search for a surgeon. Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon