Nose Bridge Needs Complete Rebuilding. Should I Go With an Implant For Rib Cartilage?

Hi. I had the lid of a glove box go through my nose bridge when I was four years old. I am now 30 and increasingly my nose is getting worse visually. I have found an ENT surgeon who with a plastic surgeon will fix it using bone from my rib. However I am in New Zealand it's the first time anyone has performed this type of surgery. I am worried after reading that perhaps there is an alternative to have it done with an implant. Is this regularly done overseas? what should I be checking with my dr?

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5 Doctor Answers | Asked by rita nz

Doctor Answers (5)
Community Comments (1)

Nasal reconstruction after trauma

For major nasal reconstruction, as you described, the surgical options include the use of your own cartilage or irradiated cartilage. I am making the assumption that your defect is substantial enough to require a large portion of cartilage (not bone as bone is not ideal in your describe circumstance). The use of your own rib cartilage is well described and is "part of you" where the use of irradiated rib cartilage is non-living, but saves you from having a chest surgery. Each have been... more

Rib Cartilage or Dorsal Graft for Nasal Reconstruction

You need to have complete faith in your surgeons ability to secure the proposed result before moving ahead with any surgery. I would suggest some second opinions so that your questions and concerns may be addressed under a direct examination. It is difficult to say which procedure would be best for you without a direct examination or any photos. I will say that you only want this done once so make sure you are in the proper hands of a skilled surgeon who has a lot of experience in... more

Michael Elam, MD

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Orange County Facial Plastic Surgeon

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Nose Bridge Needs Complete Rebuilding. Should I Go With an Implant For Rib Cartilage?

I have been a plastic and cosmetic surgeon for over 22 years and IMHO experience performing Rhinoplasty or any other procedure is key. From that point the aesthetic judgement of the surgeon allows the creation of aesthetic results. IMO, rib cartilage/bone tends to dissolve unevenly over time and for that reason, I only use straight silastic dorsal grafts when building up the nasal bridge during Rhinoplasty.

Unsure About Surgeon Before Rhinoplasty

Dear Rita, Having a rib cartilage used in a rhinoplasty is a delicate surgery and should be performed by surgeons of ample experience only. That being said please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of corrective surgeries dramatically. If you are not sure about your surgeon, it is of your best interest to have other opinions. I hope this... more

Rib Cartilage

Your Head & Neck Surgeon and Plastic Surgeon should have lots of photos of their work reconstructing noses using rib cartilage. If you are still unsure of the risks and outcome of this reconstructive procedure, seek second opinions elsewhere.

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Comments (1)

rita nz 24 Jul 2012

Thanks everyone! I had a good talk to him about the procedure. He has asked me for my approval on hip and rib cartilage as well as a bridge implant (not tip or dorsol the part that runs vertical) as he has said its a little bit unknown as to what he will find once he gets in there. He has said he will be hoping for lots of my own nose cartilage to work with but would like to have the others as options. So I'm feeling much more
Comfortable with it! Thanks so much for your help!!

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