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Nose Re-Surgery@rhino-redo

Questions about septal reinforcement

It feels like hospitals famous for removal are really divided in their opinions on septal reinforcement. But personally, unless it’s a case where the septum was truly over-harvested, I don’t think it’s necessary. Does anyone know why septal reinforcement is done.. Among four well-known removal hospitals, two said reinforcement wasn’t necessary, and that it could actually make breathing more uncomfortable. One said that in 20 years of performing surgeries, they had reinforced the septum exactly twice (you probably know where I mean). But the other two are in the “reinforcement is needed” camp. One said they reinforce it in case I might later consider revision surgery because of the shape, and also to correct nasal asymmetry. Another said they reinforce it because there is a risk of saddle nose. I can understand the first one to some extent, but I don’t really understand the second hospital. Please refer to the drawing below. The nasal bone, septum, and alar structures are all connected, and as far as I know, septal harvesting is done in an L-shape. Even after harvesting, the upper part of the septum remains in an L-shape, and the nasal bone, septum, and alar structures are all connected, so I honestly don’t quite understand how it would collapse. Also, I currently have a spreader graft. I told the second hospital in favor of reinforcement that since a nose with a spreader graft has no risk of saddle nose, wouldn’t reinforcement be unnecessary? They said there are two methods of spreader grafting (mine was a spreader graft method that supports the nasal tip; usually it’s placed on the nasal bridge, but mine was placed inside? the septum, and I couldn’t find it even when I searched). They said that if it was done with this method, reinforcement might be needed. They also said that since I had both a spreader graft and septal extension, in order to do both, the septum might have been over-harvested, so reinforcement might be necessary. I do find that part somewhat convincing. But as a counterpoint, if a spreader graft is placed on the nasal bridge, then even if the septum was over-harvested, reinforcement wouldn’t be needed, right? What I’m worried about is that because I’m so young, they might think I don’t know anything and just add on unnecessary things to make money. That thought keeps coming to mind.. My previous hospital was like that.. People seem to live fine without saddle nose after removal without septal reinforcement at hospitals against reinforcement, so I don’t understand why hospitals in favor of reinforcement do it so often haha…

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