Costal Cartilage Graft Overtime?

Hi

All cartilage grafts have risks.  They are natural tissue.  Skin, bone, cartilage, fat, all change over time.  Your face continues to change from 25 to 80.  If you did nothing to your nose and never got a nose job, your nose would be different at 80 than it is at 25.  So the people who recommend implants such as silicone are very short sighted.  Implants have lots of risks and their risks are much more serious than just warping or calcifying.  There is no perfect graft.  Septal cartilage is the best out of all the sources for rhinoplasty but its not 100% perfect.  Rib cartilage is very good but it takes years of experience with it, knowing how to carve it and how to place and secure it.  Too many plastic surgeons just take a piece and do a little rudimentary carving then shove it in the nose and hope for the best.  It takes finesse.  Probably no one has as much experience with Rib cartilage than Dr. Dean Toriumi in Chicago.  Ear cartilage has an inherent weakness in its shape and its not a good source whatsoever for the bridge.  Its ok for the tip at times but septum cartilage and rib cartilage are usually better.  

  It is always best to use nasal cartilage for revision rhinoplasty as  your primary source  for grafting and reconstruction. if the nose has been depleted of cartilage, then consideration for ear cartilage is the next step.    Rib cartilage can be used however it can have issues, such as warping,  feeling very stiff and it does ossify  and become hard  with the aging process

Dear RBrownBH, The perfect graft in revision Rhinoplasty would be completely risk free, have no complications, be easy to harvest, and offer predictable results.  Costal cartilage grafts are generally used when a large amount of cartilage is required for grafting and/or there is insufficient alternative sources (septum, concha bowl) available.  Therefore rib grafts, which have been used for various purposes for many years, offer an acceptable solution to the problems presented by revision Rhinoplasty.  Like any surgical procedures, there are risks which you have alluded to in your question.  However, autologous costal cartilage grafts offer significantly less infection or extrusion risk in Rhinoplasty than synthetic grafts.