I Had Revision for Cartilage Show-Through with Dermis-Fat Graft, but It's Showing Again — Why Absorption Is Suspected
2024. 11. 12.
A question about whitish show-through returning after revision with dermis-fat graft and cartilage removal for cartilage show-through — the judgment that the grafted dermis-fat may have absorbed and sunk, revealing the structure below, and supplementation directions like re-grafting dermis-fat or ear cartilage.
Key points
- If show-through returns even after cartilage was removed and dermis-fat grafted, the grafted dermis-fat may have absorbed and sunk, letting the structure below show through.
- In that case, options include re-grafting dermis-fat or filling the sunken area with ear cartilage so the show-through doesn't recur.
- Photos alone can't judge show-through accurately — a detailed consultation with the operating medical team comes first.
"Because of cartilage show-through, I had a revision about a year ago with autologous dermis-fat graft, and the cartilage was removed entirely. But lately that spot shows white again. There's no cartilage — why is this happening?"
A question Dr. Hyung-taek Kim of KOWON Plastic Surgery answered on Jisik iN. It was a more confusing situation because the same symptom seemed to recur even after the cause was removed and supplementation was done. Based on that answer, this article organizes why show-through can reappear after dermis-fat grafting and the directions for supplementation.
01
What was the situation?
The questioner's history organizes as follows.
| Point in time | Situation |
|---|---|
| After first surgery | Cartilage show-through noticed |
| About 1 year ago | Revision — autologous dermis-fat graft, cartilage removed |
| Now | The area that showed through is showing white again (more distinct in person than in photos) |
As the questioner said, there were parts where cartilage show-through was hard to confirm in photos. The answer first noted the premise that sharper photos would be needed for a specific answer. Still, even in the photos, the area was observed to be slightly more sunken than the opposite side.
02
Why does it show through again after cartilage removal?
The answer's estimate was absorption of the grafted tissue. The judgment was that the grafted dermis-fat absorbed and sank over time, letting the show-through of the nasal cartilage underneath appear.
In other words, rather than "showing through with no cartilage," it can be read as a situation where the dermis-fat layer that had masked the show-through thinned, letting the structure below become visible again. The finding that it looks more sunken than the opposite side also touches this estimate.
03
How can it be supplemented?
The answer suggested two directions for supplementation.
- Dermis-fat re-graft — grafting dermis-fat again into the sunken area (right side)
- Ear cartilage reinforcement — filling the sunken part with ear cartilage so show-through doesn't occur
Both methods share the same purpose — "filling the sunken part." Which fits can be judged only by seeing the actual state, so the answer closed with the recommendation to have a detailed consultation with the surgeon who operated. What to check when judging revision is covered in the revision guide.
04
Summary — it may look like recurrence, but the cause can differ
When the same symptom reappears in the same spot, it's easy to feel the surgery went wrong. But as in this case, the cause can be "absorption of grafted tissue" rather than "cartilage that wasn't removed" — and if so, the supplementation method differs too. What to fill the sunken part with is decided after checking the actual state — that's the order.
If you're curious about the cause of your nose's show-through, your current state can be checked directly in a 1:1 video consultation.
Frequently asked questions
Answers to common questions patients ask before a consultation.
Can it look like cartilage show-through even after the cartilage was removed?
Can grafted dermis-fat be absorbed?
Can show-through be judged from a photo consultation alone?
Responses to treatment and recovery progress vary by individual. Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.