Rhinoplasty is a famously difficult and intricate procedure, and the process becomes even more complicated with subsequent revision surgeries that may become necessary. With that in mind, it is truly amazing what some surgeons can accomplish on a nose that has already been operated on. Scar tissue, structural weakness, and cartilage graft issues can all make the procedure even more complex. Cartilage grafts are a major part of the rhinoplasty process, and are used in nearly every procedure, to strengthen and shape the nose. But what are some of the additional challenges of grafting during revision surgery?
Why Natural Grafts?
While there are some plastic surgeons who do prefer to use synthetic implants for rhinoplasty procedures, most surgeons today would rather use natural cartilage grafts whenever possible. This is for several reasons. First, the patient’s own cartilage is much less likely to be rejected by the body than a silicone or Gore-Tex implant. Second, cartilage can easily be harvested and carved into the shapes needed to produce good results. Cartilage also has a low rate of infection, and tends to look the most natural. Implants can be a good option for some patients, but there is always risk of extrusion and rejection.
Challenges of Grafting in Revision Rhinoplasty
There are a few major challenges of cartilage grafting in revision rhinoplasty. The nasal structure is usually significantly weakened from manipulation of the tissues and the use of septum cartilage. The surgeon must also contend with scar tissue, and be very careful to not cause issues that can turn into major problems.
Rib and Ear Cartilage in Revision Rhinoplasty
For most primary rhinoplasty procedures, surgeons prefer to use the cartilage source closest to the nose—that from the nose itself. Cartilage from the septum is usually a great choice for most grafting, but by the time the revision surgery is attempted, there often isn’t enough cartilage left in this location that can be safely harvested. The ear and the rib are the next options for cartilage sources, and they both have their ups and downs. Ear cartilage can be discreetly collected, but there is not much to spare, and this cartilage is curved and often too weak for many revision rhinoplasty applications. Rib cartilage is strong and plentiful, but it is the most difficult to harvest, and surgeons must take care with these grafts to help avoid warping over time.
As a patient, there is one major factor you can control in preventing complications in your revision rhinoplasty procedure: choosing the right surgeon. Because revision rhinoplasty is such a complex procedure, only a highly skilled and experienced specialist will be able to yield good results for most patients. Technique, skill, and artistry are the most important factors in the success of a revision rhinoplasty procedure, closely followed by good aftercare on the part of the patient. With that in mind, you should be very careful to only choose the best of the best when selecting your surgeon, and be sure to follow all aftercare instructions to the letter.
If you are looking for a rhinoplasty specialist in the Worcester (508-363-6500) or Stoneham (617-247-0033), MA area, come to Bentkover Facial Plastic Surgery and meet with experienced, board certified facial plastic surgeon Dr. Stuart Bentkover to discuss your needs for revision rhinoplasty. Dr. Bentkover has decades of experience and passion for the procedure. If you are ready to move forward in your search for a facial plastic surgeon, call either location today to schedule a consultation. Dr. Bentkover emphasizes beautiful, natural-looking results combined with excellent function, and can help you get the results you are looking for.