Risks of Using Rib Cartilage for Revision Rhinoplasty?

I want to do Revision Rhinoplasty using rib cartilage. What are the risks I face?

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12 Doctor Answers | Asked by maryam in Iran

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Risk of rib cartilage grafting

In general the risks of rib cartilage grafting include: Graft asymmetry or warping. With an experienced surgeon this risk is lessened significantly. Injury to the underlying lung during graft harvest (also rare with an experienced surgeon) stiffer nose after surgery Poor healing of the chest incision. Ask your surgeon what length incision they use (this varies among surgeons). The chest incision typically heals very well. risks of surgery in general such... more

Rhinoplasty Revision with Rib Cartilage Grafts

I prefer to use septal or ear cartilage for nasal grafting when possible. Rib cartilage is primarily used when larger quantities of material are needed. There are additional possible complications using the ribs, but if necessary, it is a good choice. Discuss the procedure with your surgeon. Your goal should be the best possible result, understanding all advantages and disadvantages of each procedure.

Richard W. Fleming, MD

9 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

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 another site - either 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 framework. Drawbacks of Rib Cartilage... more

Risks of Rib Cartilage Rhinoplasty

Thank you for the great question. Using autologous (from you) rib in rhinoplasty is generally safe. The long-term complication that is most feared with costal cartilage grafts is warping -- or shape change/curvature of the graft material over time. Certain techniques are used in surgery to limit this, but it is unfortunately not completely predictable. The other possibility is graft resorption (the grafts don't survive and the nose loses volume again).The alternatives in cases where a... more

Revision Rhinoplasty and Rib Grafts

Optimally, one of the most important aspects in rhinoplasty, both primary and secondary, is to use autologous tissue if needed. These are the most challenging operative procedures that we do in aesthetic plastic surgery, therefore, it’s very important to choose an experienced rhinoplasty surgeon. Find someone that has significant expertise in secondary rhinoplasty surgery as this is a very challenging and difficult operative procedure. One can never totally restore one to a normal nose... more

Rod J. Rohrich, MD

10 reviews

Dallas Plastic Surgeon

Rib cartilage risks

Rib cartilage's main advantage is its plentiful supply. The main risks of rib cartilage are: Risk of pneumothorax- Pneumothorax is a "popped lung". This can occur when harvesting rib from the chest area. This is not common with an experienced rib revision surgery. Risk of warping- Warping can occur with rib cartilage. Decreasing the incidence of warping significantly by experience in carving costal cartilage. There are several... more

Revision Rhinoplasty and rib cartilage

When large quantities of cartilage are needed in revision rhinoplasty, rib cartilage can be the best solution. But, to avoid the scarring, pain, and possible lung puncture of harvesting your own cartilage, rib cartilage can be obtained from a tissue bank safely with no higher a complication rate than using your own cartilage and with the advantage of decreasing your operative and anesthesia time. Please look up this paper to see our experience with over 1000 such grafts with long term... more

Silastic Dorsal Implant Vastly Superior

One of the most challenging aspects of revision Rhinoplasty is choosing material that will age in a predictable manner with the patient. Tissue that warps, partially dissolves or in some other manner causes nasal irregularities should be avoided. After more than 20 years using various materials for Rhinoplasty and Revision Rhinoplasty these are the ones I use. For the nasal tip, ear conchal cartilage is the best. For the nasal bridge, which is your particular case,... more

Rib cartilage use in revision rhinoplasty

You have several good answers but you may consider use of bone from scalp which in my experience is less painful and with well hidden scar with no warpping and good long term survival. But, must be done by an experienced rhinoplastic surgeon. Other sources are cadaver cartialges as well as silicone implants that work well.

The major risk with rib cartilage is warping.

Rib cartilage has a tendency to bend and warp over time. This is the biggest risk. The other major issue with rib cartilage is the morbidity of getting rib cartilage. It does create a scar and is quite painful in the donor site. Based on your picture alone, I would recommend ear cartilage with a PDS perforated plate. I seldom need rib cartilage, and seem to always find enough cartilage between auricular and remnant septal cartilage.