Should I get a revision rhinoplasty using rib graft? Will it make my nose bigger? I have very thick skin

Question

My skin is very thick and as seen in the first photo, definition was very noticeable due to steroid injections, the picture on the right is my nose now, Skin has thickened and is without steroid injections. I am now 2 years post op. My surgeon who did my primary would like to use rib graft and place it in the columella to show the shortening like in the First picture of my nose with steroid injection. Will this make my nose bigger? He also wants to increase height of the bridge in my nose.

Thomas A. Mustoe, MD, FACS · Answer

A rib graft that is properly shaped will not necessarily make your nose larger although that it is a risk, unless it is signifincantly trimmed, and cartilage and or bone are removed to make room for the graft. I agree that the bridge could be elevated, but cartilage grafts whether from the rib, septum or ear all have associated risks of shifting positions or having an edge become visible.  They would not necessarily help the loss of definition of the tip which is due to scar tissue underneath the skin. without an in person consultation it is difficult to make firm recommendations, but I would probably recommend revision with removal of the scar tissue, and the use of cartilage grafts as necessary for support, but I doubt that rib would be necessary.  Close followup with steroid injections as necessary can often improve the tip definition, but not always.

Gary Motykie, MD · Answer

I would have your surgeon perform computer imaging of your nose to make sure you are on the same page as far as the result you would like to achieve from surgery. A rib graft will undoubtedly make your nose appear larger.

William Portuese, MD · Answer

There are many alternatives to augmenting the nasal bridge, and they include nasal septal cartilage, rib cartilage, ear cartilage, and synthetic implants. Each one has  their own advantages and disadvantages, which is best discussed at the time of examination and consultation. Revision rhinoplasty is one of the hardest operations to perform correctly  in the entire field of cosmetic surgery, so choose your surgeon very wisely based on experience

Should I get a revision rhinoplasty using rib graft? Will it make my nose bigger? I have very thick skin

Answers (3)

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Should I get a revision rhinoplasty using rib graft? Will it make my nose bigger? I have very thick skin

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.