What Is The Best Source Of Cartilage Grafts To Replace An L-Shaped Silicone Nasal Implant?

Q: Dr. Eppley, I’m actually planning to have a revision rhinoplasty done at the end of the year to remove the L-shaped silicone implant that was initially placed. But I am just curious as to what my options are. If I would like to get a sharper and lowered nose tip, together with a higher nose bridge and some glabella augmentation, do you think a silicone implant for the bridge and ear cartilage for the nose tip and glabella would be preferable to rib grafts?

A:By definition, to replace the existing L-strut  silicone implant in your nose you would need the same dimensions and that would mean a rib graft. Even with lowering the tip I think there is the need for just too much cartilage to rely on an ear conchal graft alone. This would be particularly true when trying to make the nose tip more defined (pointy) as it would be much safer and and more effective to have a strut graft ‘doing the pushing’ so to speak. Such a graft harvest would then allow a more complete rhinoplasty to be done with the dorsal bridge and glabellar area to be cartilage grafted as well

Dr. Barry Eppley

Indianapolis, Indiana