Q: Dr. Eppley, I am interested in revision rhinoplasty. I have a problem with my deviated nose. This is the result of the rib cartilage placed in my nose which has become deviated. I had a nose job done in 2011 in Korea. It was fine at that time but now the deviation of the nose is very visible. My nose was originally not deviated like it is now
1. My question is whether it is possible to also have a nose surgery to remove that rib cartilage and replace with a good and straight implant. I just want a straight nose, the nose tip and wings are ok.
2. How much of the cartilage can you reuse and how much ear cartilage you need to harvest for the tip?
A: Unfortunately rib cartilage does have a tendency to warp in some patients creating a subsequent deviated nose. You have several revision rhinoplasty options considering that it is just the bridge part of the rib graft that is the issue. (and not the tip) These include the following:
- Remove the dorsal part of the rib graft only and replace with an implant
- Remove the deviated part of the rib graft, morselize it into small pieces and replace it as a diced cartilage graft without using an implant.
The decision between these two revision rhinoplasty choices depends on whether you just want to straighten the nose only or straighten it with further augmentation along the line of the bridge.
Dr. Barry Eppley