I am going to have a revision in the next month and I saw 3 surgeons. I need to have cartilage added to the side of my nose from the supratip all the way to the bone. One surgeon said he would use the cartilage from behind my ear and the other said from inside my area. What is the difference and why would you use one over the other? How does cartilage gets added to the side of the nose, does it get crushed, do you put a piece of it in? Does it make a difference which area you take it from?
Cartilage Behind Ear Vs. Inside Ear?
Doctor Answers (10)
Cartilage Grafts From Ear For Rhinoplasty
It is likely that the two surgeons are referring to the same piece of cartilage, only with different incisions. The cartilage can be crushed or left unaltered, depending upon the purpose it is serving. Kenneth Hughes, MD Los Angeles, CA
Cartilage Behind Ear Vs. Inside Ear?
There are several areas to get cartilage from to be used as a graft in the nose such septum and ear and rib. The approach to the ear cartilage can be from the anterior approach or the posterior approach.
Ear cartilage approach
Patients having revision rhinoplasty commonly need cartilage grafts to replace/rebuild missing structures. Often ther is not enough nasal septal cartilage so the surgeon must go to the "spare parts box". This is usually the ear or rib depending on what is needed to be rebuilt/replaced. It sounds like you are referring to the approach. Ear cartilage can be harvested from an anterior Inside the ear) or posterior (behind) approach. The cartilage is the same, it's just the way it is being harvested. Either way is perfectly fine and I would leave the decision to your surgeon on what works best for him/her. How it is used (crushed/carved etc) is also determined by individual needs-there is no set "rule" or way.
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Cartilage graft to nose
For the type of revision problem that you are describing cartilage grafting is typically necessary. based on the size, shape, pliability, and amount of cartilage needed the possible donor sites include:
- Septum - from inside of nose
- Ear - ideally taken from the back through a hidden incision
- Rib - taken through an incision under the fold of the breast
Ear cartilage for the nose
Ear cartilage can be harvested either through an anterior approach or posterior approach. Good luck.
Ear Cartilage Grafting to the Nose
Those are just two different incisional approaches to harvesting conchal(ear) cartilage, postauricular (behind the ear) vs preauricular (inside the ear). The ear cartilage would need to be modified, either morselized or crushed, to have it sit well without visible edges or being able to feel it when placed onto the nose.
Ear cartilage graft from behind or in front part of the ear,
Ear cartilage graft from behind or in front part of the ear for me depends on what i am using it for. If I don't need skin with the graft (which it sounds like what you are saying) then I get the cartilage from behind the ear. If I need skin with it, then the front of the ear.
Ear cartilage is often used in revision rhinoplasty and can be harvested different ways
The approach different surgeons use to harvest ear cartilage is really a matter of personal choice. I prefer acessing the ear cartilage from in front. That way the ear is never "detached." The incision heals so well that it's rarely detectable. Other very respected surgeons harvest the same cartilage through an incison on the back of the ear. That way there is no way the incision could be seen, but the ear needs to be detached to remove the cartilage, then reattached.
Either way, choose the surgeon who you have the most confidence in rather than specific details about their technique.
Ear cartilage for rhinoplasty
- He/she may be referring to the access sites to the ear
- You can place the incision along the back or the front of the ear, both incisions heal very well
- When you harvest the cartilage, you use what you need and cut it into precise grafts
- Crushed grafts are used if you need just a thin piece of cartilage for augmentation
Cartilage grafts from ear
Taking it from the ear is common and there are varying ways to get it. Whether taken from inside the ear or from behind, the cartilage harvested is the same. The cartilage is added to the nose in pieces or crushed, depending on the need at-hand. Sometimes a combination is the best way.