Rhinoplasty - Rib Cartilage Absorption

Question

Hello, I recently had an augmentation rhinoplasty with my own rib cartilage and the surgeon purposely over-augmented the graft to compensate for absorption. I think it looks too big now at 10 days post op. So, I was wondering what factors determine how much rib cartilage is absorbed? Thank you very much

Thomas A. Lamperti, MD · Answer

I agree with the others that rib cartilage doesn't typically resorb. You will have significant swelling of the overlying skin and soft tissues, though, that would give the appearance of over-correction. You have to give it time to heal and evolve.

Steven Wallach, MD · Answer

I usually use a graft of the exact size I want.  I do not think that they resorb too  much.  However, what you may be experiencing is soft tissue swelling and I would give it time to resolve.

Mohsen Tavoussi, MD, DO · Answer

It is too early to worry about cartilage absorption. This, if occurs, may take a long time. Healing will take over a year or so and there will be a lot of swelling particularly after revision rhinoplasty.

Darryl J. Blinski, MD · Answer

This was a major surgery and at 10 days very hard to tell if a cartilage rib graft is to large. Be patient to allow healing over the next 6 months. Resorption occurs SLOWLY so continue with your visits with your chosen surgeon at least once a month.

Michel Siegel, MD · Answer

In my experience there is no visible resorption of rib cartilage. If it looks too big it may be from swelling of the skin envelope, the graft is too big, or it is mal-positioned. 10 days may be too early to tell, unless you submit photos.

	Michel Siegel, MD

Richard Ellenbogen, MD (retired) · Answer

I think that resorbtion does occur to a small degree, however, I think at this point in your surgery, you have a significant amount of post-operative healing. Over the next few weeks, you will find that this swelling improves and will find a more aesthetically pleasing result.

Richard W. Fleming, MD (retired) · Answer

I've not found that there is significant absorption of rib cartilage grafts used in rhinoplasty. Hopefully the fullness is secondary to temporary normal post-op swelling as we discussed in our previous communication.

Francis R. Palmer, III, MD (retired) · Answer

Yes, it's well documted in the literature that rib cartilage and bone absorbs after use in a Rhinoplasty.  The problem is that the absorption is not uniform along the length of the graft and occurs randomly like taking chunks out of the segemnt resulting in a wavy distortion of the graft with dips and peaks. 

	 IMHO, rib cartilage or bone should not be used in building up the nasal bridge for this reason.  Since it's in, you may just want to wait and see if the absorption becomes an aesthetic problem and if it does, plan...at that time, to have it removed and replaced with a straight silastic dorsal implant during a Revision Rhinoplasty.  Until then, do nothing.

Donald Nunn, MD (retired) · Answer

Usually you do not over augment the nose expecting resorption. Autologous rib grafting like you had usually has very low resorption. Your nose is probably still very swollen at ten days post op and may take longer than with a non augmented rhinoplasty to settle down. Discuss this with your surgeon. Donald R. Nunn MD Atlanta Plastic Surgeon.

Rhinoplasty - Rib Cartilage Absorption

Answers (9)