LAM FACIAL PLASTICS

Hello Dr.

I had a hump removed about 8 months ago and my doctor used spreader grafts which I wasnt told would be placed before the procedure. Now my nose looks much wider that before. He told me that my nose would narrow with time but it doesn't seem to be happening. Can the spreader grafts be removed?? And if they are removed will it cause my nose to look deformed?? Or will it just go back to its normal width? The middle part of my nose is so wide its almost as wide as my nostrils it look so odd? Any advise?

Ilse

The spreader grafts can be removed but with difficulty. If he put them in there, there was probably a reason. Plus, he is right. Noses continue to go inward along the middle vault (where your spreader grafts are) for the next few years.
best,
sml

Do the spreader grafts fuse together with the surrounding tissue or to they just sit in the pockets that were created to place them? Just curious.. When ever I yawn there is a flicker on one side close to where my nostril begins. I don't know how to explain it..kind of like if you flick one of your finger nails with the other it really bothers me. Will that go away with time?

I don't know about the flicker issue but the spreader grafts become fused. They need to be pried out.

Thank you Doctor.

you are welcome!

Hello Doctor,

I have really been considering getting the spreader graft removed. I have gone to three different consultations. Two of the doctors did say that my nose looked over widened but that I should still wait at least the full year. I was told that most likely there would not be any significant chage by then but it was still a good idea to wait. I am planning on waiting another 3-4 months. I want to give it a bit more than the year and hope for the best but I really do not see much changing.

One side really bothers me. The other feels pretty normal, but the bad one almost feels like it was possitioned wrong I cant explain it. If I push in and upward on the side of my nose its almost like my nose get a little brake form being pushed out (a sense or relief per say). Well I hope I explained in a way that you can somewhat understand and give me some advise.

My question to you is very important to me. What risks will I be taking by removing the spreader grafts? Is it a good idea to take pre op x-ray in order to get a good look at the grafts (on side is much thicker than the other) and their positioning to better determine the outcome.
Also very important, have you ever removed spreader grafts? And if so what did you think of the results?

Blessings

hi,
first, i have removed spreader grafts but they are very hard to remove. you just have to cut out the spreader graft. i am not keen on doing it. second, the risk is that the middle vault of the nose collapses inward and you have nasal breathing problems and a collapsed middle third of the nose. third, oftentimes the nose thins after a spreader graft but not typically in the first year. it does so within the first 5 years. that may be longer than you want to wait.
best,
sml

Good Morning Dr.

Im sorry for all the questions but I value your advise a great deal and don't want to jump into anything that may be a huge mistake. Please bare with me thank you.

Will and X Ray help determine a more accurate outcome? How difficult is the surgery? does it require an open approach or can it be done with a closed procedure? Approximately how long does it take and can it be done under a local anesthetic or does it have to be general.

Five years is a long time but my whole life is longer so I want to make an educated decision. I am glad to hear that you have done this before making your advise very valuable. Thank you again for your time.

Blessings.

1. i do not believe an xray will help.
2. i have only done it through an open approach as it is very hard to access from a closed technique (near impossible).
3. i would do it under general anesthesia.
i would be honest with you. it is not something i routinely do and would not be comfortable doing it for you. you should ask someone with a ton of experience removing these. i don't have extensive experience removing them.
best,
sml