Is ear cartilage adequate for typical Asian Rhinoplasty patient?
Doctor Answers (14)
Rib vs. ear cartilage for augmentation during Asian rhinoplasty
The reason rib cartilage provides a greater degree of refinement is because it provides more structure since it is stronger. Greater augmentation (or building of the bridge) is also possible because there is more cartilage available from the rib. In addition, for projecting, lengthening, or counter-rotating the tip of the nose, rib cartilage grafts are often necessary to provide long-lasting results.
As you can imagine, ear cartilage is softer and there is not as much of it available. For mild to moderate augmentation, ear cartilage in combination with septal cartilage (cartilage from inside your nose) will suffice, but for more dramatic augmentation rib cartilage is necessary.
Some rhinoplasty surgeons prefer ear cartilage due to their discomfort in harvesting rib cartilage in a minimally invasive way, and so will recommend only ear cartilage. Consulting with an Asian rhinoplasty specialist who does a high volume of Asian rhinoplasties using ear and rib cartilage will give you the best option regarding your exact nose.
Ear cartilage grafting in Asian rhinoplasty
Chase Lay, MD
Double board-certified facial plastic surgeon
Asian facial plastics specialist
Asian Rhinoplasty and ear cartilage
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With more extensive changes greater amount of cartilage would be needed.
Another consideration besides the amount of cartilage available is the quality/strength of cartilage available for rhinoplasty. Ear cartilage isn't usually strong enough to create septal extension grafts to provide significant nasal lengthening. Septum cartilage is often strong enough though that's not always the case and there may be inadequate amounts of cartilage available for use.
Rib cartilage (either from yourself or from a tissue bank) is another potential cartilage source. This would provide a large enough volume of strong cartilage if needed.
You can read more about Asian rhinoplasty and see before and after photos at my web reference link below.
Asian Rhinoplasty and ear cartilage graft
It is best to consult with a plastic surgeon who has a lot of experience with Asian rhinoplasty.
I routinely use a combination of cartilage from inside the nose and the ear cartilage to create better shape.
Typically, these graft may be used with fascia to create natural looking result with improvement in the dorsum and tip area.
Rhinoplasty and dorsal augmentation
Typical Asian rhinoplasty patient
Advantages of using rib cartilage:
1) No septal cartilage or ear cartilage needs to be harvested. Rib cartilage can be used for the tip graft, septal extension graft (and any additional grafts) and building up the bridge of the nose and radix.
2) The rib cartilage can be cut into a very straight piece for use as the septal extension graft. If there is a crooked septum you will not have a good straight piece for this procedure.
* Rib cartilage is fairly quick and easy to harvest and most of my patients go home the same day and return to light activity in one week.
Advantages of using ear cartilage:
- Avoid incision and scar on the chest
* A disadvantage is the harvested piece usually has a curve to it. I would only use it to dice and place in harvested fascia for use on the bridge of the nose. It is not ideal if a septal extension graft or tip graft is needed.
I would recommend a consultation with a rhinoplasty surgeon who has experience in Asian rhinoplasty using either rib cartilage or ear cartilage. He or she will be able to give you more information on the degree of augmentation required and the type of cartilage recommended for the procedure.