When Did E.N.T.'s Start Doing Rib Cartilage Harvesting for Revision Rhinoplasty?

About ten years ago you never heard of an e.n.t/facial plastic surgeon harvesting rib cartilage for grafting in the nose. I believe only general plastic surgeons performed such surgery. Did the medical college loosen any regulations that allowed for this or is this because rib cartilage grafts in nose are more commonly performed today & e.n.t.s/facial plastic surgeons now take extra accredited training courses?

Doctor Answers (7)

Rib cartilage for revision rhinoplasty

+2

A good historical question; see previous answers that otolaryngologists and facial plastic surgeons have indeed been harvesting rib for some time.  I have a busy revision rhinoplasty practice, and rarely use autogenous rib.  Most of the time septal or ear cartilage, and sometimes cadaver rib suffice.  We also have seen an uptrend for nonsurgical rhinoplasty (restylane, perlane, radiesse to fill nasal defects) because of higher risks and costs of revision surgeries.


New York Facial Plastic Surgeon
4.5 out of 5 stars 29 reviews

When Did E.N.T.'s Start Doing Rib Cartilage Harvesting for Revision Rhinoplasty?

+2

 Facial Plastic Surgeons have been harvesting rib cartilage for grafting use in Rhinoplasty for well over 25 years IMHO.  It's not my first choice for grafting material in Rhinoplasty as it has a tendency to absorb unevenly over time creating irregular contours in the nose.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Revision Rhinoplasty

+2

This is a good question.

The previous responses are correct. Otolaryngologists who do Rhinoplasty were using Autogenous Rib grafts when I was in Med School in the 70's. I have been using rib cartilage since 1976. 

Richard W. Maloney, MD
Naples Facial Plastic Surgeon
4.0 out of 5 stars 4 reviews

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Rib cartilage for rhinoplasty

+2

  Both facial plastic surgeons and plastic surgeons perform rib grafts for nasal reconstruction.  Its very important to go to reconstructive/ Cosmetic rhinoplasty specialist who has extensive experience in noses.  Rib grafts are not used very often unless there is  reconstructive needs  that  are too extensive for nasal and  ear cartilage

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Look up the history of Rhinoplasty

+2

First lets get the definitions straight.  ENTs are not Facial Plastic Surgeons but Facial Plastic Surgeons 95% of the time are also ENTs.  Regardless both ENTs and Facial Plastic Surgeons have done Rhinoplasties for centuries.  In fact the very first Closed Rhinoplasty was done by an ENT surgeon.  The first Open Rhinoplasty was done by an Orthopedic Surgeon.  ENTs do major facial reconstructions.  They remove large tumors and cancers from the face creating gigantic holes then reconstruct them with bone, cartilage and soft tissue from various parts of the body including skull, scapula, hip or ribs.  These are ENTs we are talking about.  Facial Plastic Surgeons have even additional training beyond their training in ENT but its not necessary.  ENTs are certified by the ABMS (the same Parent Board that certifies Plastic Surgeons) to do all this major reconstruction so a revision rhinoplasty with rib cartilage is minor in the greater scheme of an ENT's training and practice.  In fact the first FACE TRANSPLANT in the United States was performed in Cleveland Clinic by a Facial Plastic Surgeon with an ENT background.  

 

With all this said, Plastic Surgeons, ENTs and Facial Plastic Surgeons (all 3) are certified and capable of major facial and nose surgery using rib cartilage but each individual surgeon will have a different training and comfort level.  Some ENTs will do better nose jobs than some Plastic Surgeons and some Plastic Surgeons will do better nose jobs than some ENTs.  It just is what it is despite the marketing hype you may hear online or by some doctors.  All three specialties are highly trained and qualified to do this surgery but you have to judge each individual surgeon.  Just remember, Michael Jackson's surgeon was the Head of the Greater Los Angeles Plastic Surgery Society and he was an experienced Plastic Surgeon, not an ENT! 

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 38 reviews

ENT's and Rib Grafts

+1

The term ENT is a sort of slang for Otolaryngologist-Head and Neck Surgery, a regional surgical specialty of the head and neck.  Harvesting rib grafts is a basic technique for head and neck reconstruction, as it is for facial plastic surgery.  As for facial plastic surgery, the major influence on many techniques in modern plastic surgery was an Otolaryngologist named Sir Harold Delf Gillies.  Therefore, one could say that facial plastic surgeons (who are generally Otolaryngologists) "start" doing rib grafts when they start their training, just as general plastic surgeons do.  As far as rhinoplasty goes, a well trained and experienced facial plastic surgeon or plastic surgeon should suit your needs

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
5.0 out of 5 stars 35 reviews

Rib Cartilage for Rhinoplasty

+1

Rib cartilage is a versatile material for nasal reconstruction and revision rhinoplasty.  ENT Surgeons and Plastic Surgeons alike harvest rib cartilage for nasal reconstruction and have done so for quite some time.  The real question is does your surgeon perform this procedure on a regular basis?  Experience counts a great deal when harvesting and using rib cartilage. 

Jay Calvert, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 24 reviews

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