Cartilage graft on nose tip is bulky and uneven after revision rhinoplasty. Can it be removed and how long do I need to wait?

I had revision rhinoplasty 6 months ago and my own nose cartilage was used for a graft at the tip. I have thin skin and the graft is very noticeable (diameter of a dime but thicker with indentations where it starts and stops). I hate how it looks and would much prefer how I looked before. Is it possible to have the entire graft removed? What are the risks - could it create a hollow area, or might separating the graft from the skin cause a tear? I had no dents or deformities in the tip before.

Doctor Answers 3

Nasal Tip Graft/Shield Graft is Bulky and Uneven

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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

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Dear Helen360,

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.

Tip grafts

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Yes, the tip graft can generally be removed. That being said, there was probably a reason the surgeon placed it there in the first place. If it is removed with nothing else done, you may have an undesired outcome. I would either consult with your initial surgeon or find another surgeon who can evaluate you in person and discuss your options in depth.

Best of luck

David Reinstadler, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.