Ask a doctor

Possible Ear Cartilage Warping from Rhinoplasty?

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.

Doctor Answers 18

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 been operated on in a major way (NOT YOU, is still there. It definitely would be a better choice.

Good Luck.

Memphis Plastic Surgeon
5.0 out of 5 stars 80 reviews

Cartilage Warping


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 cartilage is very rigid and resists deformation over time better than ear cartilage. Again, both are great options in very specific indications. For tip elevation and a tip-plasty, I typically use septal cartilage if it is available. If it is not and we need structurally rigid support, I then move to rib cartilage.

Make sure you excert all your options and see as many Board Certified surgeons as you can to gather as much information as you can with regard to your particular case.

I hope this helps!

Good Luck-

Dr. C

John Philip Connors III, MD, FACS
Atlanta Plastic Surgeon
5.0 out of 5 stars 31 reviews

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
5.0 out of 5 stars 22 reviews

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 your surgeon if there is some reason for not using septum in your case. Good luck, /nsn.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 6 reviews

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
4.5 out of 5 stars 13 reviews

"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 from your septum? If so, this may be why the surgeon wants to use ear cartilage. If not, ask if the surgeon can use your septum as the donor for the cartilage.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

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 discuss with your surgeon why he does not wish to use septal cartilage and especially if the purpose is to lift your tip since septal cartilage is inherently straighter, longer, stronger and generally does not warp. I hope this information helps.

Scott Trimas, MD
Jacksonville Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

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
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

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
5.0 out of 5 stars 143 reviews

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 support and rotate your tip.

I hope this is helpful, and best regards.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 328 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.