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  • It is currently Mon May 20, 2013 12:57 am

Rib graft to build up bridge - can it be rasped or removed?

This section of the forum is dedicated to discussions on rhinoplasty (cosmetic, reconstructive, and functional) nose surgery, also known as a “nose job”. Ethnic rhinoplasty topics can be addressed either here or in the Ethnic Cosmetic Surgery Forum.
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Rib graft to build up bridge - can it be rasped or removed?

Postby DeltaB » Wed May 27, 2009 7:46 am

Hi Dr Lam

Firstly, I would like to express my thanks for all of the interesting information you provide through this website.

My situation involves recent revision rhinoplasty in the USA to correct a partial V-deformity, an overly scooped profile with a wide/washed out frontal view and an overly rotated tip (and breathing difficulties). My primary rhino 4 years ago was way too aggressive, as I was seeking purely conservative hump reduction.

The tip grafting done in my revision have been a success, even with slight swelling still present in the tip from an open approach.

However, the cadaver rib graft used to build up my bridge is a BIG problem. Apparently I have above average skin thickness, so a boat shape block graft of rib was used (without fascia wrap). Now with much of the swelling settled, it's become evident that my bridge graft is too high, too stiff, has overly prominent edges, doesn't blend into my nose at all....etc. There's an awful shadow cast along each side due to it not blending. Plus, my skin looks shiny and almost stretched over it. It's so obvious where it even takes off at the root of my nose. I feel like there's a pork spare rib sitting slightly crooked under my nasal skin (it's not sitting center in my nose). My nose looks really harsh and roman-like.

I'm waiting for a miracle, hoping it might scar down a bit flatter. But I'm not hopeful. It's getting worse each week. Both my family and husband agree that it's a poor outcome and that it needs to be addressed :oops:

My general query is this - can a rib graft like this be removed/replaced with ear cartilage/resized/rasped ????
I waited so long to have a revision done. However, I'm not happy with my bridge result at all. It looks way worse than my overly scooped nose did, which was unatural, "not me" and bad enough :(

I noticed in a previous post that your preference is not to use rib at all. I guess my case is a good example as to why!

Any thoughts would be greatly appreciated. Thanks Dr Lam!
DeltaB
 
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Joined: Wed May 27, 2009 6:57 am
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Re: Rib graft to build up bridge - can it be rasped or removed?

Postby dr. lam » Wed May 27, 2009 10:34 pm

i'm sorry to hear of your situation. i prefer silicone micro droplets to manage small degrees of scooping. rasping is really something that i think is hard to do with rib grafts. at least, i don't have experience to that effect. you should probably ask the surgeon who put it in if he has experience with it. hope that was some minor help. just trying to be honest with my responses.
best,
sml
Samuel M. Lam, M.D., F.A.C.S.
Diplomate, American Board of Facial Plastic & Reconstructive Surgery
Diplomate, American Board of Otolaryngology Head & Neck Surgery
Diplomate, American Board of Hair Restoration Surgery
dr. lam
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Location: Dallas Texas
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Re: Rib graft to build up bridge - can it be rasped or removed?

Postby DeltaB » Thu May 28, 2009 2:07 am

Thanks Dr Lam. I totally respect and appreciate your honesty about rib grafts in this sort of scenario.

I guess I'll pluck up the courage to ask my surgeon about my potential options....if there are any :(

Thank you anyway for responding to my query!
DeltaB
 
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Joined: Wed May 27, 2009 6:57 am
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Re: Rib graft to build up bridge - can it be rasped or removed?

Postby dr. lam » Thu May 28, 2009 5:41 am

best wishes with everything! i hope things settle down so you don't need any revision.
namaste,
sml
Samuel M. Lam, M.D., F.A.C.S.
Diplomate, American Board of Facial Plastic & Reconstructive Surgery
Diplomate, American Board of Otolaryngology Head & Neck Surgery
Diplomate, American Board of Hair Restoration Surgery
dr. lam
Site Admin
 
Posts: 4996
Joined: Wed Oct 03, 2007 10:51 am
Location: Dallas Texas
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