Cartilage Grafting in Rhinoplasty: Dr. Athre Explains the Procedure

[@lisae6725]

I'm one month post revision Septoplasty with nasal valve reconstruction, Submucosa resection, right Choncha Bullosa resection, and Rhinoplasty with Cadaver Rib Graft. I'm stil having a lot of swelling and uneven healing which I heard is not unusual with revision but it is hard on me emotiionally to wonder if it's going to even out. I just made the decision that I'm not taking daily pictures anymore, nor am I going to look at my nose everytime I use the bathroom because it is making me feel crazy and super depressed which I really don't want to go through. I do believe I picked the right surgeon for the job in my state. He is double board certified as a specialist in ENT, and plastic surgery reconstruction particularily of the nose. I have to have faith in my surgeon at this point. My results after my 1st Septoplasty/Rhinoplasty were much more obvious immediately after the cast came off because I had a very large nose with a dorsal hump, boxy tip, and was extremely crooked from falling face first down on to my nose in to the concrete floor in grade school. My only issue which ended up why I needed the revision was because they said they forgot to get my consent for rib cartilage so they used everything they could but to be very careful because my nose was very fragile. Well, around 16 years later and I noticed my nose shape changing again and by the time I went in again at 20 years later, my tip was very twisted and I had my left quarter to half view being very unattractive with my left nostril getting larger and larger while I had esentially a total collapse on the right. My nose was crooked on one side and I swear I could practically see it happening in real time by the time I made the decision to try and fix this mess again so that the rest of my life is spent on other things verses being a hermit who felt hideous beause of my nose deformity. This has been a roller coaster ride on my emotions and I hope that I will be satisfied by the this time next year. Good luck to everyone here who knows exactly what I'm going through.

[@MemberOfLight]

How did you recovery go? Can we get an update?

[@Maxmaxmax63]

Can I talk to you? Legit getting this same exact procedure. Revision septoplasty, rib cartilage, spreader grafts, turb reductions, left choncha bullosa. Surgery is 10 days away.

[@superpiccirillo]

Your story is pretty much the same as mine…..and I’m 18 days post op and the swelling and shape and hardness is much more then I expected. How did yours go in the end? Where are you now in your recovery ?

[@usersal-f6i]

Dr. Athre, Your information is absolutely the best I've heard and explained. Thank you. I had ear cartilage removed for my deviated septum and Open Rhinoplasty but my nose is long and the tip not elevated. Can you advise me please ? I'd be very grateful. Post Op 2 months. Not happy. Went to PPSI Phuket. If it needs revision I can see you.

[@raghuathre5667]

Thanks @alisonaus2300 Hopefully it all goes well!

[@jswagg317]

I just had septoplasty turb reduction nasal valve repair surgery 1 month ago. I now hav a collapsed nasal valve .how long b4 it can be fixed. How long should i wait for revision surgery. Im having major problems breathing correctly. And really need it fixed now

[@xorqwerty8276]

I had the same surgeries 1 month ago and now have the same issue. What did you discover?

[@raghuathre5667]

6 mos to 1 year is when a revision is contemplated/performed

[@fushiigso7145]

How can you know it collapsed?

[@tacosmargs58]

My midvault collapsed and I need revision. Do you think ear cartilage is good for permanent support?

[@raghuathre5667]

ear cartilage is normally great for camouflage. Not so great for support

[@tacosmargs58]

@@raghuathre5667 I've had my revision since I posted this comment, and ear and cadaver rib were used. I'm 7 months post op and doing well

[@raghuathre5667]

@@tacosmargs58 Awewome Cheryl. Good luck!

[@helunanova]

Dear Doctor, thank you so much for your great and helpful advice. I have severe nasal valve collaps and the doc wants to use ear cartilage. However after watching some surgery videos, knowing how severe my nose is collapsing, i strongly feel that ear cartilage won't be strong enough. What type of cartilage would you recommend for severe cases of nasal valve collapse? What is meant by the warping of rib cartilage? Thank you so much in advance! It's so hard to make a decision and every doctor tells me something else

[@raghuathre5667]

Warping means the following....Rib cartilage has a natural curve. We want the nose to be straight. The natural curve of rib has a tendency for grafts made of rib to take on a slight curve over time unless certain procedures to counteract this are followed. #2 I look at cartilage grafting in 2 categories: structural and space occupying for contour. Ear is great for contour but cannot withstand the forces necessary for structural. If you are here in the USA, we would be happy to give you a consultation with a game plan. We see tons of out of town patients and can see if you would be a good candidate for revision surgery. Good luck.

[@helunanova]

@@raghuathre5667 thank you so much for the very important Information! This is Helping me so much! I'm from Germany, and sadly I havent found a good doctor until now who is really able to explain this as you did. If you could recommend a colleague in Germany, it'll be great! Anyways, I'm considering visiting you in some years if I don't find a German doctor I can really Trust. It is my 3. Rhinoplasty so this time it has to be the last one... again, thank you so much. Now I know what type of advice I need from German doctors. May I ask you one more question. Do Rib cartilage alar batten grafts inside the nose warp in the inner or in the outer Directon? So, are the nostrils gonna get wider or smaller over time?

[@raghuathre5667]

@@helunanova It is hard to make a generalization regarding all alar batten grafts. In general, I FEEL that alar batten grafts make the nostrils appear wider and thicker. I do not use them frequently. However, in a few instances they may be necessary.

[@helunanova]

@@raghuathre5667 thank you so much, again, for the helpful advice. I'm gonna send an Email to your clinic soon. I haven't gotten such a professional and detailed advice of any of my doctors but this is what I'm searching for. Thank you! 🙏🙏

[@raghuathre5667]

🤗@@helunanova

[@ktiwana89]

Brilliant information! Thank you for sharing your expertise!

[@AthreFacialPlastics]

My pleasure! Thanks for watching!

[@LaLaBlahBlahh]

I had a rib cartilage nose job but it warped so now I’m having another rib cartilage rhinoplasty... really hoping the same doesn’t happen again! Why wouldn’t you use a combo of ear for contour and rib for structural support?

[@AthreFacialPlastics]

That is exactly what is done. Combos of rib, ear, and septal cartilage (and occasionally irradiated cartilage) are used.

[@americaamaro4425]

I want to get my first rhinoplasty and my dr wants to use ear cartilage, im scared it'll warp!, how long ago did you get your nose done?

[@raghuathre5667]

@@americaamaro4425 normally ear cartilage is not necessary for a first time rhino. Also, ear cartilage normally does not warp.

[@ashwiniravikumar9318]

I had Diced cartilage fascia graft rhinoplasty, it appears to be Crooked... Can i get it removed and replaced?

[@AthreFacialPlastics]

Yes, it is possible. May require an additional cartilage graft.

[@DK-ox7ze]

Hi doc, I am going for a revision rhinoplasty to bring down the tip and also lengthen my nose. My nostrils are more visible from the front, hence I am going for a revision. Which cartilage is best for that?

[@fushiigso7145]

How did it went?

[@DK-ox7ze]

@@fushiigso7145 Haven't went for it yet but he said he will take ear cartilage. Are you also considering a similar rhinoplasty?

[@fushiigso7145]

@@DK-ox7ze yeah I had like á dropped nose tip or at least you could see my nustrols but they made my nose longer they projected it and ad rib Carl in my nose tip they’re also put my nustrols closer, but I don’t know it’s only the tip but I feel like my nose is longer and bigger and i can’t find anyone on KZbin that had something similar im not sure if my nose will get smaller or not because it’s just the tip pff 1 month post up

[@DK-ox7ze]

@@fushiigso7145 Is it possible for you to share your nose pics?

[@Jadedrtb]

@@fushiigso7145 please tell me how it went ! I need an update

[@ninivecocoy4220]

Outstanding information, wow and I just wasted 100 dollars consultation on a lousy, lazy doctor that did not explain anything at all. Great video

[@syntheticsoundtracks]

why cant you just use titanium or something? why do you have to remove material from the nose to put it somewhere else?

[@raghuathre5667]

The nose is a structure where the internal lining has quite a bit of bacteria, etc. 1. Natural materials (i.e. materials from your own body) have a lower chance of infection, will integrate to the natural skeleton over time, and have a longer life span. Artificial materials tend to get infected or extrude over time. This is different than bone for example where titanium screws are used frequently

[@helunanova]

What do you think of the titanium batten graft technique from Doctor Daniel a Wengen?