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Beverly Hills Plastic and Cosmetic Surgery “Tip of the Day” from Beverly Hills Plastic and Cosmetic Surgeon, Dr. Francis R Palmer, III.

Beverly Hills Plastic and Cosmetic Surgery “Tip of the Day” from Beverly Hills Plastic and Cosmetic Surgeon, Dr. Francis R Palmer, III.

Rhinoplasty and Revison Rhinoplasty:

Sometimes during a Rhinoplasty or a Revision Rhinoplasty it may be necessary to use a graft to add support and/or shape to the nasal tip or nasal bridge. What are the choices and the best materials to use where? Are all materials the same?

No, all materials are definetly not the same. Some materials used as grafts tend to have many more complications and problems years after the Rhinoplasty or Revision Rhinoplasty. The following are my choices for graft materials with over 20 years experience performing Rhinoplasty and revision Rhinoplasty.

1. Nasal Tip: This area of the nose needs a soft material that will not absorb , dissolve or thin the overlying skin.

my choice: the curved section of the ear cartilage called conchal cartilage makes an excellent graft to the nasal tip…best of all it’s your own tissue.

my advice to avoid: L-shaped silicone implant where 100% erode through the skin within 15 years. Man made substances like Gortex and medpore that may become infected years later for no apparaent reason.

2. The nasal bridge: The graft should be strong, straight and not absorb.

My choice: Silicone dorsal grafts that come in different sizes and thickness…has a very real shape that’s similar to a normal aesthetic nasal bridge. No L-shapes, just the straight dorsal segments.

To avoid: Conchal ear cartilage tends to dissolve unevely when used on the nasal bridge. The same can be said about bone, rib cartilage and banked (irratiated cartilage). Uneven absorptiuon means deformity and this should be avoided as this will most likely result in a Revision Rhinoplasty to replace this graft with one that is more stable. Septal cartilage works well here but rarely can a piece be found that’s long enough to cover the entire distance of the nasal bridge.

Choosing the correct graft is a major part of proper pre op Rhinoplasty or revuision Rhinoplasty planning. The wrong graft or implant may mean a revsion Rhinoplasty in the future…so this is worth learning.

Dr. Francis R Palmer, III