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Possible Ear Cartilage Warping from Rhinoplasty?

asked 2 years ago by Frank45 in Edinburgh Texas
Latest answer by William Portuese, MD
Question viewed 2,480 times
Tags: ears, nose, cartilage, septum, tip

I have an appointment for a tiplasty where the tip of my nose will be lifted. The doctor said he will use an ear cartilage strut to do this but as I have done more research I see that ear cartilage "warps".

My question is, what exactly does "warp" mean? What are the chances of it "warping" and is it normal for a doctor to use ear cartilage instead of septum cartilage from someone who has never had a Rhinoplasty done before? Thank you.

18 answers to Possible Ear Cartilage Warping from Rhinoplasty?

Nasal Cartilage Grafts

The best source of cartilage for nasal grafts is the septum, if available. Warping is the change of shape of cartilage after the graft is placed. Although it is possible with ear or rib grafts, this is very,very rare.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Septal cartilage is preferred for rhinoplasty

Indeed, warping can occur from ear cartilage and rib cartilage. Septal cartilage does not tend to warp, bend, or bow. It is always best to have any cartilage grafting performed from the nasal cartilage first. If the nasal cartilage has been depleted, then move on to ear cartilage.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Cartilage Warping

Frank- Ear cartilage is higly specialized, thin deformable cartilage that is used all the time for nasal surgery, mainly in reconstruction, and primarily in areas where fine-tuning needs to be performed. Warping occurs as the scars heal and contract over time...these forces can uncontrollably deform the cartilage and twist the results. I am a big fan of ear cartilage in very specific circumstances or when other sources are not readily available, i.e. septal cartilage from inside the nose. Septal more

John Philip Connors III, MD
Atlanta Plastic Surgeon

Rhinoplasty tip surgery and grafts

Ear cartilage can be used for rhinoplasty surgery. It tends to be more flexible and therefore give less support than septal cartilage. For that reason, septum is my personal preference for refining the tip. "Warp" refers to the tendency of some cartilages, including ear cartilage, to bend with time and lose their shape. It's hard to predict the actual chance that this might happen given individual variation. Septal cartilage does not have this tendency. You may want to ask... more

Nina S. Naidu, MD
New York Plastic Surgeon

Septal cartilage better to provide structure

Ear cartilage, which is thinner than septal cartilage, will warp. For smaller more delicate uses ear cartilage can be ideal. For more structural uses septal cartilage tends to be better.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon

"Warping" can occur with any cartilage. Why not use the septum?

You have asked some interesting questions. "Warping" is when the cartilage implant bends, or changes shape. This may happen to cartilage implants, but is not usually a problem with the strut you have described. Ear cartilage is not very straight to begin with--so it's not my first choice for a tip strut. I prefer to use septal cartilage--which is generally much straighter. You mentioned that you had never had a rhinoplasty--but have you had a septoplasty--was cartilage removed... more

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon

facialplasticsurgerymd.com

Cartilage warping after rhinoplasty

Cartilage warping after rhinoplasty can occur and may not even be visible until many years after the procedure. The absolute best cartilage for rhinoplasty surgery is your own septal cartilage if it is available. Septal cartilage rarely if ever warps and is always in my opinion the best and should be the first choice. Now if you have had septal surgery before that cartilage may not be available; however, if you have not I would recommend that cartilage be the first choice. You should... more

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon

Tip plasty

All good questions. Warping is when the cartilage actually bends after it is placed in a given pocket. This can happen with any cartilage graft. Although some surgeons prefer to sue ear cartilage for small grafts, I prefer septal cartilage. It is stronger.

Steven Wallach, MD
Manhattan Plastic Surgeon

Ear cartilage can be used for rhinoplasty

Dear Frank, Ear cartilage is not typically used if you have never had rhinoplasty. It doesn't have the same support as septal cartilage and has a greater chance of warping. It will also leave an unnecessary scar on your ear. I do use ear cartilage grafts in revision rhinoplasty when there is insufficient septal cartilage or if I am reconstructing missing convexly-shaped portions of the tip that have been over resected. Ask your plastic surgeon for his rationale. Good luck!...

Ran Y. Rubinstein, MD
Manhattan Facial Plastic Surgeon

Septal Cartilage Grafts used during Rhinoplasty Surgery work well to support and elevate your tip.

If you've never had a previous rhinoplasty, I'm not sure why your surgeon is suggesting the use of ear cartilage. Septal cartilage is stronger, straighter, easier to harvest, and won't leave a scar on your ear. If your surgeon is experienced, you'll get a good answer. If not, please get a second opinion. I've attached a link to my rhinoplasty photos for your perusal. Just about all of my Rhinoplasty patients have septal cartilage grafts (Columella-struts), since they work well in helping to... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Personally I like septal cartilage as a first choice, it is stronger than ear

There are a number of choices for cartilage grafts for the nose. My preference is septal cartilage. It tends to be stronger and straighter than ear cartilage. They are actually different kinds of cartilage. Not only is ear cartilage weaker, but just look at your ear, the cartilage is already inherently curved, so getting a straight piece is much harder. I cannot judge the surgeon you chose, but someone should be comfortable with all aspects of nasal surgery to do the best rhinoplasties. more

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

Rhinoplasty and Ear Cartilage

Hi Frank, "Warping of cartilage" means that the cartilage can twist out of shape over time. If ear or rib cartilage is not used correctly, there is a higher chance of warping. In primary rhinoplasty, the choice of cartilage graft is septal cartilage. Septal cartilage is especially good for tip refinement. Ear cartilage is usually reserved for revision rhinplasty. Harvesting septal cartilage may not be familiar territory for all surgeon, therefore the choice of ear cartilage. Best... more

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

www.facechange.org

Rhinoplasty Cartilage Grafts, Septal Cartilage vs. Ear Cartilage?

Hi Frank, You are correct. Nasal septal cartilage is preferred to ear cartilage for nasal grafts because it is structurally stronger cartilage and much less likely to warp (bend its shape). It is most unusual for a rhinoplasty surgeon to take ear cartilage when "virgin" septal cartilage is available. Why create another surgical site when the cartilage can be taken from inside your nose? I guess these are questions that you need to address with your rhinoplasty surgeon. Good... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Septal cartilage is preferred.

Ear and septal cartilage are actually two different types of cartilage (elastic and hyaline, respectively) and have different mechanical properties. While any cartilage graft can warp (twist or deform over time), septal cartilage tends to be more useful structurally. You're also correct that most surgeon's--myself included--will use septal cartilage over ear cartilage, if it's available. Most patients undergoing their first (and hopefully last) rhinoplasty will have adequate septal cartilage... more

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

Cartilage choice in Rhinoplasty

All sources of cartilage in the body can warp or twist with time-- some plastic surgeons even try to support the cartilage by inserting a stainless steel wire through the cartilage first as an added support, and have had excellent results with this technique (It looks like you're from Texas, and I believe this is done by some of the surgeons at UT Southwestern in Dallas). Some folks believe ear cartilage is less likely to warp, others disagree, so it does come down to the surgeon's choice--... more

Shahram Salemy, MD
Seattle Plastic Surgeon

www.drsalemy.com

Warp in Rhinoplasty

For starters, this "warp" has nothing to do with Star Trek and space travel at the multiples of speed of light. Warped simply means twisted, bent or twisted or deviated. When we need to lift a heavy nasal tip and keep it up, its support must be sturdy. If the cartilage strut support bends/warps/twists, so will the nasal tip it supports. (Think the Tower of Pisa...) Cartilage from the septum is sturdier, thicker and straighter than ear cartilage and, unless your septum had already... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Ear or Septal cartilage for the nose.

Cartilage warping occurs when a piece of shapede cartilage becomes distorted or deformed. This is possible at any time and can effect any caritlage. Septal cartilage tends to be the first choice and I would ask your surgeon for the rationale in choosing ear cartilage.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Cartilage warping

It is possible for cartilage from any source, ear, rib, or septum to warp. This means it will twist and become misshapen. Each surgeon has their own preference as to what source of cartilage will work best for your situation. If you are not totally comfortable with your doctor's plan, see someone else for another opinion.