Why is a Graft Needed During Revision Rhinoplasty?
Revision Rhinoplasty is performed to improve the results of previous Rhinoplasty. This can be to improve breathing, the appearance of the nose, and often both. Graft material is almost always needed during this complex surgery to correct and maintain the form and function of the nose.
Types of Graft
The common grafts that I use in revision rhinoplasty are:
Spreader grafts – to open up airway
Alar baton grafts – for symmetry and to prevent nostril collapse
Septal extension grafts – to improve and maintain tip position
Alar rim grafts – to improve nostril shape
On certain occasions I will also use dorsal only grafts to increase the height of the nasal bridge.
The patient’s own septum is the ideal place to harvest graft but often will have been damaged or taken during the previous surgery. Ear cartilage is not strong enough to provide the support required. Rib cartilage is therefore the best option.
Cadaveric Grafts, and Why I Use Them
I personally made the switch from using the patient’s own rib to cadaveric rib graft 3 years ago. The advantages of using cadaveric rib graft are as follows:
1. No additional surgical site: The biggest advantage of using cadaveric rib is there is no need for an additional surgical site. Harvesting rib cartilage requires a separate procedure which adds to the operation time and/or requires an additional surgical team. It will result in a visible scar on the chest and potentially an indentation where the graft was taken. Most importantly, by using cadaveric rib cartilage instead of the patients own rib we avoid the risk of lung damage (pneumothorax).
2. Day-case surgery: By avoiding the need to harvest the patient’s own rib, revision rhinoplasty using cadaveric rib graft enables the surgery to be done as a day-case. This means the patient can go home the same day. Our surgeries are performed at 101 Harley Street in the heart of London’s medical district.
3. Abundant supply: The amount of graft required varies from patient to patient. With cadaveric rib there is no limit to the amount of graft available. This means it can be carved and shaped to fit the specific needs of each patient making it highly customizable.
4. Long-lasting results: Cadaveric rib grafts are strong and durable. Studies have shown that resorption and warping rates are comparable to the patients own rib (Saadi et al 2019).
I firmly believe the risk and morbidity associated with harvesting the patient’s own rib is too great to be worthwhile when cadaveric rib is available as an alternative.
How Safe is Cadaveric Tissue?
Our trusted supplier of Cadaveric Tissue, Hospital Innovations, says: "Very. The tissue bank who supply the cadaveric tissue are the largest private tissue bank in the UK; and have been supplying cadaveric tissue for over 15 years. Donors go through rigorous screening and testing before tissue recovery and there are various stages of processing prior to sterilisation. These important steps in testing, processing and sterilisation ensure the cadaveric tissue supplied is safe for use."
Contact us
Want to know more? Contact our friendly team who will gladly answer all your questions.
The deep plane facelift recovery journey follows a predictable timeline that helps patients understand what to expect during their healing process. During the initial 24-48 hours, patients experience the most intensive recovery period, requiring dedicated rest and careful monitoring. Swelling peaks around day three, with significant improvement noticed by the end of the first week.
Most patients see dramatic improvements in swelling and bruising between weeks two and three. By week four, approximately 75% of swelling has typically resolved, though subtle changes continue for several months. The complete healing process typically spans 6-12 months, during which time incisions fully mature and final results become apparent.
Otoplasty, also known as ear correction surgery, is a sophisticated surgical procedure designed to improve the appearance of prominent or misshapen ears. This transformative treatment encompasses both ear pinning and reshaping techniques, allowing surgeons to address various aesthetic concerns. At our Harley Street clinic, we specialise in both traditional ear pinning, which reduces the angle between the ears and head, and comprehensive reshaping procedures that can modify the ear's structure. The procedure is suitable for both children (typically over 5 years old) and adults who are concerned about protruding or asymmetrical ears. Ideal candidates should be in good general health and have realistic expectations about the outcome. The surgery can address various concerns, including prominent ears, asymmetry, abnormal ear folds, and ears affected by injury or birth defects.
The Deep Plane Facelift represents the pinnacle of modern facial rejuvenation techniques, offering comprehensive restoration of facial aesthetics through advanced surgical methodology. This sophisticated procedure addresses multiple layers of facial tissue, providing more natural and longer-lasting results compared to traditional facelift approaches. By targeting the deep muscular aponeurotic system (SMAS) layer, surgeons can achieve remarkable improvements in facial contours whilst maintaining natural expression and movement. The procedure's scientific foundation lies in its unique approach to facial anatomy, working with rather than against the natural tissue planes. This results in reduced tension on the skin, minimising the risk of the dreaded 'pulled' appearance often associated with conventional facelifts. The technique particularly excels in addressing mid-facial sagging, nasolabial folds, and jowl formation - common concerns that traditional facelifts may not adequately address.
