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COVID-19 Reopening Updates View Update Virtual Consultation

Rhinoplasty or a nose job is one of the most technically challenging operations performed by plastic surgeons not just in San Diego, but the entire country as well. As a result, many doctors are not trained to a sufficient degree on the intricacies of the operation. 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 able 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 text book chapters on the subject.

If you are in need of 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 help you understand what is possible in revising your original operation.

Reasons for Revision Rhinoplasty

The main reasons for revision rhinoplasty include dissatisfaction with the results of the first surgery, improper healing of the nose after the first surgery, or the removal of excess scar tissue. For revision rhinoplasty patients, there are a number of ways to reconstruct the nasal framework. These methods include harvesting cartilage from the ear, septum, or even the ribs. Most often cartilage will be harvested from the septum first, the ear second, and the ribs last. While grafting cartilage from the ribs is often the last option, it is an equally viable option. Here are some important things to know about harvesting cartilage from the ribs in order to perform a revision rhinoplasty.

Why Use Rib Cartilage

Dr. Vincent Marin usually prefers to harvest cartilage from the septum during a revision surgery, but 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 be used to support the nasal tip, one of the most important features in a nasal revision surgery.

Where Rib Cartilage Comes From

There are a couple different options to choose from when it comes to grafting rib cartilage. It is possible to use the patient’s own 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 wonder if it is safe to use grafted cartilage. Before the cartilage is even accepted into the donor bank, it is screened thoroughly for any type of 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.

Risks

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. In very rare 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 that are associated with grafting cartilage from the patient’s own body include cosmetic issues, such as the visibility of the grafts 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.

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TO OUR MARIN AESTHETICS PATIENTS:

In light of the state wide restrictions on non-essential businesses to help reduce the spread of COVID-19, we are rescheduling all of our elective appointments until the global circumstances improve. Our necessary post-operative appointments will be made, as needed, to address immediate surgical concerns such as suture removal and acute postoperative issues. All non-acute follow up appointments, fillers and Botox will need to be postponed until after the quarantine period mid April. Our office will reach out to all patients who need to be rescheduled.

We will be offering new patient virtual consultations online and via Skype that can be scheduled through our website or by emailing info@marinaesthetics.com. Also, we will offer follow-up appointments in the same manner to help manage our patients’ concerns while still respecting the need for social distancing.

We appreciate all of your understanding during these difficult times for all of us.

Stay safe,

Dr. Main and the Marin Aesthetics Team