How safe is rib cartilage for Rhinoplasty compared to gortex or silastic? How sure are we about finding some cartilage from the rib?
Is Rib Cartilage New for Rhinoplasty?
Doctor Answers (15)
Rib cartilage is safe in Rhinoplasty
The choice between rib vs. Gortex or Silastic has to do with using a natural material instead of a foreign (yet well tolerated substance). There are pros and cons for both. Rib is from your own body, and cartilage can almost always be found, that is based on standard human anatomy. There are some risks from obtaining the rib, but they are low. The main drawback is chest discomfort for a few weeks.
Rib cartilage use for rhinoplasty procedures
Rib cartilage is used for rhinoplasty procedures in the event that there is no internal nasal septal cartilage or ear cartilage available. At that point, once the nose and ear cartilage have been exhausted, other reconstructive consideration can be entertained such as Silastic implants. We do not prefer Gortex in the nose because of the amount of infections that we have seen in our practice. Rib cartilage can also be used, and there is plenty of that available. However, it does take a separate incision located underneath the breast, and a 2-inch incision necessitated to go in and harvest the rib cartilage.
Understanding Rib Cartilage Grafts
In revision rhinoplasty, it is usually necessary to reconstruct and reshape the nasal framework using cartilage grafts. Because available septal cartilage has usually been removed during the first surgery, grafts must obtained from another site - either the ear or the rib.
Rib cartilage has many uses and advantages in revision rhinoplasty. It can be carved or shaped to the desired configuration. Its rigidity can provide support to a weakend nasal framework.
Drawbacks of Rib Cartilage Include:
* Rendency to warp (curve). This can make the result unpredictable.
* Nose may feel firm or inflexible.
Potential Risks of Rib Cartilage Harvest:
* Prominent scar
* Collapsed lung (pneumothorax)
* Chest wall deformity
However, in experienced hands, rib cartilage allows successful results in revision rhinoplasty
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Rib cartilage and rhinoplasties
Rib cartilage is fantastic for use during rhinoplasties. In fact, it is associated with less risk of infection comparted to gortex and silicone. It is safe and reliable as the inner portion of all ribs transition from bone to cartialge when they reach the sternum. Good luck!
Rib cartilage for Rhinoplasty just one arrow in the quiver
Rib cartilge is natural and abundant. Most likely for more invasive problems that require a large amount of material. It also requires a piece of metal wire placed through it to insure a straight result. This type of cartilage has a tendency to warp.
Nose Jobs (rhinoplasty) and rib (costal) cartilage grafts or silastic (silicone) or gortex (PTFE)
This is an ancient technique and has been around for a long time. It is nothing new. The rib can come from you or a donor. Silastic is probably the most common synthetic implant and is more commonly utilized in the Pacific Rim. It can get infected or move or exposed and occasionally needs to be removed. IT can provide significant bulk. Gortex is used as a thin sheet and typcally is not used to enlarge but rather to smooth the nasal bridge.
Rib Cartilage is Useful for Rhinoplasty
Each surgeon has their preferences regarding this topic. My preference is to use material that is natural in the body such as rib cartilage or ear or nasal septal cartilage. In cases in which the nose or ear has already been used or significant amount of cartilage is required, rib is an excellent choice. I use this under these circumstances and have been happy with the results.
Your own tissue is almost always better than synthetic material, especially in nose surgery
While probably the best material for grafting in the nose is the cartilage from the septum of your nose rib cartilage is also excellent if large pieces are needed or the septum is not available. Other choices that are better by far then Gortex or silastic are ear cartilage or bone from the outer table of the scull. I would not consider using Gortex or silastic. Many others feel differently but long after the surgery you can have trouble with these none autologous materials.
Rib cartilage is safe for rhinoplasty
Rib cartilage is an excellent source of material when nasal augmentation or reconstruction is necessary. Other autologous (form your own body) sources of augmenation for rhinoplsty include: septum cartilage, ear cartilage, skull bone, or hip bone. Rib cartilage is plentiful and relatively easy to harvest, and therefore, commonly used in rhinoplasty when significant augmentation is necessary.
Rib cartilage and other autologous sources have the advantage of reduced risk of infection or rejection when compared to foreign sources such as Gortex or silastic. The disadvantages of rib graft include: the need for a chest wall incision, added time and additional required expertise.
You should review these factors with your surgeon before choosing one option vs another.
Rib cartilage is not new
There are pros and cons to EVERY material that is used for rhinoplasty surgery. Risks from rib cartilage have to do with both the procurement of the cartilage/bone and the response of the tissue once is placed into the nose. Harvesting rib cartilage requires a scar on the chest, may cause several weeks of pain and can even puncture a lung. Once transferred to the nose, although usually a solid, long lasting material, the graft can change shape or even dissolve somewhat. Other materials, so called "off the shelf" products, such as silastic or gortex, involve no harvest site morbidity and are very stable over time. However, these products are more likely to have infection or extrusion (exposure) risks. Your rhinoplasty surgeon may have a preference for one or the other, but you should be receptive to risks in either case. Good luck!
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.