Cartilage graft on nose tip is bulky and uneven after revision rhinoplasty. Can it be removed and how long do I need to wait?
Doctor Answers 3
Nasal Tip Graft/Shield Graft is Bulky and Uneven
I am sorry to hear that you having a difficult time. Tip grafts are a great tool that can be used to modify the shape, projection, and rotation of the nasal tip. However, tip grafts also strengthen the nasal framework and can exert pressure on the overlying skin. When the skin is thin, visible edges and irregularities in the graft may become noticeable. If the graft projects too high above the other cartilages it can look odd and stiff, and is known as a "tombstone" deformity. It is usually safe to remove the graft, however it is rarely necessary. The graft should be beveled to have soft smooth edges at all the contact points with the skin. The height and width of the graft can be modified also if needed. Finally, it is very helpful to cover the graft with a small piece of your own tissue (muscle or fascia) to provide a bit of cushion between the graft and your skin. I suggest that you return to your surgeon to politely discuss your concerns and find a suitable solution. My best.
Cartilage Graft Still Bulky
It is definitely possible to remove the cartilage graft and reshape it. If you have thin skin and the graft is noticeable, commonly the graft is either crushed or some of your own fascia is placed over the graft to make it less noticeable. It is possible that removing the graft could create a hollow area and if you have very thin skin and the graft is showing through the skin, it is possible to cause a skin tear, however, your surgeon should be able to assess this with good accuracy beforehand.
Best of luck