Revision Rhinoplasty: Q&A
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Major Risks of Revision Rhinoplasty Using Rib Cartilage?
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12 Doctor Answers |
Asked by
maryam
in Iran
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Use of rib cartilage in revision rhinoplasty
There are three types of cartilage used in revision rhinoplasty. The first choice is always cartilage from the septum, as it is straight, firm cartilage which does not require harvesting from outside of the nose. In cases where septal cartilage has already been used during previous surgery, the next choices are ear and rib.
Ear cartilage can be excellent for certain smaller grafts but tends to be weaker than septal cartilage and may not be strong enough for reconstructing noses which...
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Rib grafts are a good option
If the nose needs structure, then the first place the surgeon looks is inside. However this usually isn't an option because the loss of cartilage/bone is the reason the surgeon is looking for material. Therefore we go farther a field. First the ear or both ears, then the rib. We used to use the skull and before that, the pelvis.
The problems with rib are the extra site of surgery, possible local complications (although these are rare), and the quality of the cartilage is...
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Rib Cartilage
Rib cartilage is most often used in nasal surgery when a larger amount of cartilage is needed. In experienced hands the potential complications are minimized. If I personally needed a rib graft for my revision rhinoplasty, I would have the procedure without hesitation. For a list of specific possible complications, ask during your consultations.
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Rib cartilage for rhinoplasty
Rib cartilage is often used in rhinoplasty for patients that need augmentation of their nasal bridge. Harvesting the rib is fairly straightforward. It will leave a permanent scar on the chest that is usually no more than a few inches long. The biggest complication from the harvest is a potential for a pneumothorax ( collapsed lung).
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Rib Cartilage Grafting for Revision Rhinoplasty
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 either another site - 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 framewoek.
Drawbacks of Rib Cartilage...
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Risks of revision rhinoplasty using rib (costal) cartilage
The risks are generally low when performed by an experienced surgeon but they can include (and are not limited to):
infection, bleeding, hematoma, wound breakdown, hyperftrophic or keloid scar formation, contour irregularity, hemo/pneumothorax, graft resorption or warping, overcorrection, undercorrection, graft rotation/extrusion/exposure, inability to acheive a specific funtional and/or cosmetic result.
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Major risk of rib cartilage is warping
Rib cartilage is notorious for warping. It tends to have a memory and tends to warp after time. I alos find rib cartilage to be a bit too stiff which undoubtedly leads to a nose that is a bit too stiff.
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Long term results with rhinoplasty and rib grafts
The risks of rib cartilage harvest and grafting really relate to graft uptake. The expertise of the surgeon will determine whether there is graft uptake and survival, thus maintaining longterm surgical results.
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Rib Cartilage Risks for Rhinoplasty
The use of rib cartilage is one that should only be done by a surgeon highly experienced in its use. First of all, there is the risk of lung collapse during the harvest of the implant (assuming it is going to be your own and not a cadaver rib). Once placed, with healing if not secured properly the rib can migrate, leaving asymmetries and other cosmetic problems of the nose. Lastly, the rib can fail to secure, becoming a moveable piece under the nasal skin.
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Rib cartilage is an excellent choice for rhinoplasty
Cartilage from the rib is a very good choice in rhinoplasty surgery. The risks include injury to the lung and pleura. There is some pain after the procedure. In experienced hands this cartilage can be an excellent choice to allow an exceptional result. There is a risk of warping of the cartilage, so the surgeon must be exacting in carving the graft.
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Risks of rib cartilage in revision rhinoplasty
Today there are many different techniques that can be employed in a revision rhinoplasty. If the patient does not have adequate tissue or requires a strong internal framework, the surgeon may use a portion of the patients rib. This can provide sufficient good-quality and strong cartilage to correct any deformities and provide support. The risks that go along with rib harvesting and rib grafts include a depression in the area of your chest where the rib section was removed, a possibility...
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Considerations for rib cartilage grafting in revision rhinoplasty
The three sources of cartilage utilized in rhinoplasty are the nasal septum, the ear, and the rib. Often in a revision surgery, the septal cartilage may have been uilized previously, or altered to improve the airway. Therefore the rib may be necessary, as it provides ample material which is structurally quite sturdy. Ear cartilage is a much softer, pliable material. It is important that a surgeon take the rib safely, and minimize the impact of the scar. Additionally, rib has the...
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