In rhinoplasty, there are many important techniques that are used to achieve a variety of goals. However, one of the most important techniques that is used in almost every rhinoplasty, no matter what the issue, is cartilage grafting. This involves harvesting cartilage from one area of the body and shaping it to give the nose structure and change the shape. If you have already gone through a rhinoplasty once, then you know how the process works. However, if your results were not exactly what you were hoping, then you may be facing a second surgery. When it comes to revision rhinoplasty, things are a little bit different for cartilage grafting, which sometimes includes a different harvest site for the cartilage. So what do you need to know about grafting and revision rhinoplasty?
A Secondary Source May Be Necessary
Harvesting cartilage is very straightforward, but the preferred sites for source cartilage can change with a revision rhinoplasty. Ideally, material for the procedure is taken from the nasal septum or, if not enough cartilage can be taken from this source, the ear. However, these sources are often depleted after the first rhinoplasty procedure, and surgeons often turn to a third source for cartilage: the rib area.
The Pros and Cons of Rib Cartilage in Revision Rhinoplasty
Though it is typically the least-preferred type of cartilage for rhinoplasty, this does not mean that rib cartilage is a poor choice for rhinoplasty. Benefits of using rib cartilage are that there is plenty of material for use in specific contexts, and a low risk of rejection by the body. The downsides of using rib cartilage include a more invasive procedure that involves the rib and chest area, and the possibility for cartilage warping (minimized with an experienced surgeon).
No Cartilage at All?
While most surgeons prefer to use natural cartilage whenever possible, there are situations in which synthetic implants are used in lieu of cartilage. These nasal implants are generally made of solid silicone or Gore-Tex and are used in similar ways to cartilage. For most cases, the risks tend to outweigh the benefits, but if used properly, the results of using nasal implants can be extremely successful.
Is Rib Cartilage a Good Idea?
When it comes to using rib cartilage, it all comes down to the specific situation and the skill of the plastic surgeon. Only an expert can determine whether or not the use of cartilage is appropriate for a given patient, and a board certified rhinoplasty specialist will have the skill to manipulate the cartilage to provide a beautiful outcome. Another reason to be careful in your choice of surgeon is safety. Rib cartilage harvest is more invasive than taking material from the nose or ear, and your surgeon will need to take special care to avoid complications relating to retrieving the cartilage.
Revision Rhinoplasty: No Easy Matter
Any type of rhinoplasty is an extremely complex process, and not an operation all plastic surgeons are qualified to perform. Revision rhinoplasty is a notoriously difficult surgery, and many plastic surgeons who offer primary rhinoplasty may not have the confidence or expertise to tackle secondary procedures. So why is the surgery so much more difficult the second time around? It has to do with a few factors. First, the nasal structure has already been altered, often resulting in a weakened structure. Because of this, surgeons have to be careful to preserve functionality and make sure the nose has adequate support. Second, scar tissue from the first procedure can interfere with the surgeon’s efforts, making it more difficult to achieve the desired results. The stakes are also extremely high as patients are usually upset about their negative first experience and just want to get their problem fixed.
Finding a Surgeon
With this in mind, how do you choose your plastic surgeon? Fortunately, there are many talented, compassionate, ethical, and experienced surgeons offering revision rhinoplasty. If you do not think your original surgeon will be able to give you the results you want, then it is time to start consulting with revision specialists. Choose a reputable and skilled surgeon with whom you have rapport, and do not settle on your choice of surgeon. When setting up your consultations, only talk to board certified experts with an excellent track record of great results and safe practices.
Dr. Stuart Bentkover has dedicated much of his long and respected career to the art and science of rhinoplasty. Truly passionate about the procedure, Dr. Bentkover has helped many diverse patients get beautiful, custom results from revision rhinoplasty procedures. If you would like to discuss your goals with Dr. Bentkover, call Bentkover Facial Plastic Surgery in Worcester (508-363-6500) or Stoneham (617-247-0033), MA today to schedule a consultation.