Rhinoplasty or a nose job is one of the most technically challenging operations performed by plastic surgeons in San Diego and the entire country. As a result, many doctors are not trained to a sufficient degree in the operation’s intricacies. This can leave their patients with a less than satisfactory result, thus, needing a revision rhinoplasty.
Since this is the second, third, or even fourth operation in some patients, there can be considerable scar tissue and damaged cartilage or bone from the previous operations. Although not always the case, frequently, additional cartilage will be needed, and your surgeon will have to “borrow” this from your ear or rib. This allows your doctor to rebuild the collapsed areas or fractured cartilage with fresh tissue to maintain its shape long term.
This does require a second incision to harvest the cartilage, which is then carved into the proper shape to help rebuild specific areas of the nose. Not many surgeons have experience with this technique or procedure and frequently don’t offer it to their patients. Dr. Marin has extensive experience with this procedure and has authored textbook chapters on the subject.
If you need a revision of your previous rhinoplasty or nose job procedure, contact our San Diego Plastic Surgery office at 858-638-9800 or online at MarinAesthetics.com/contact to schedule an in-person consultation with Dr. Marin. He can evaluate your situation and perform computer imaging to understand what is possible in revising your original operation.
Reasons for Revision Rhinoplasty
The main reasons for revision rhinoplasty include dissatisfaction with the first surgery results, improper healing of the nose after the first surgery, or the removal of excess scar tissue. For revision rhinoplasty patients, there are several ways to reconstruct the nasal framework. These methods include harvesting cartilage from the ear, septum, or even the ribs. The cartilage will most often be harvested from the septum first, the ear second, and the ribs last. While grafting cartilage from the ribs is usually the last option, it is an equally viable option. Here are some essential things to know about harvesting cartilage from the ribs to perform revision rhinoplasty.
Why Use Rib Cartilage
Dr. Vincent Marin usually prefers to harvest cartilage from the septum during revision surgery. Still, sometimes this is not possible, as the cartilage from the septum may have been used in the previous rhinoplasty procedure. In this instance, Dr. Marin will use rib cartilage to add support to the nose. Rib cartilage is sturdy and often the perfect match for the cartilage in the nose. The rib cartilage can even support the nasal tip, one of the essential features in nasal revision surgery.
Where Rib Cartilage Comes From
There are a couple of different options to choose from when it comes to grafting rib cartilage. It is possible to use the patient’s rib cartilage, but this can often leave an undesirable scar. It also can be somewhat painful to the patient after the surgery. It is also possible to use rib cartilage from a cartilage bank. To accomplish this, surgeons will use grafts of cartilage that was salvaged from healthy donors. Many wonders if it is safe to use grafted cartilage. Before the cartilage is even accepted into the donor bank, it is screened thoroughly for any systemic disease, excess radiation, or any other issues that may be problematic. Since the cartilage undergoes such a rigorous screening process, it is safe to use for rhinoplasty revision surgery.
In general, using rib cartilage for rhinoplasty revision surgery is considered safe. As with any procedure, however, there are potential risks. Most of these risks involve risks associated with grafting cartilage from the patient’s own body. Rib cartilage is usually harvested by making a 2 to 3-cm incision, which can be made under the breast. On infrequent occasions, this incision can cause damage to the underlying lung tissue. However, this is extremely uncommon and can easily be managed following the procedure. Some of the complications associated with grafting cartilage from the patient’s own body include cosmetic issues, such as the grafts’ visibility under the skin or shifting of the grafts.
To schedule a rhinoplasty revision surgery, contact the staff at Dr. Marin’s San Diego office. They will be happy to schedule a consultation at your earliest convenience.
*The content in this blog is developed to spread the awareness towards plastic surgery. Our blog is not intended to serve as a replacement for an actual in-office consultation with Dr. Marin. As such, the information within this blog reflects the unique cases of our individual patients.