Adding Rib Graft to Make Nose Bridge Larger? Doctor Answers, Tips
Rhinoplasty: Q&A
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Adding Rib Graft to Make Nose Bridge Larger?

I had Rhinoplasty and my surgeon cut the nose and made my bridge small. If I want it larger, is there a way to ADD a rib graft? Or would it have to be replaced completly? Can the nose be made as big as the patient desires, or are there limitations?

15 Doctor Answers | Asked by zaddy123 in CO
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Role of Rib Grafts in Rhinoplasty

The role of rib grafts in rhinoplasty is to add significant dorsal augmentation, projection, and for reshaping especially in ethnic noses or secondary rhinoplasty. This does require an additional donor site. It has some discomfort, but it is overall a good operative procedure that must be done in the hands of an experienced rhinoplasty surgeon.
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Nose bridge can be made larger rib graft

Since you have already had a reduction rhinoplasty, it is best to wait at least a year before embarking on further rhinoplasty procedure. If indeed you do want the nose larger, there is a way to add cartilage to the nose to build up the bridge. The first alternative would be to use nasal cartilage, and the second alternative would be to use ear cartilage, and the third alternative would be a rib graft. It is impossible to make the nose too big, and there are limitations to the skin... more
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Raising a Low Bridge with Rib Grafts

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. It works particularly well for... more

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Rib Grafts in Nasal Surgery

The bridge can be enlarged using cartilage grafts, but I prefer to harvest the cartilage from the nasal septum or the ear. Rib grafts are my last choice because this approach is more difficult for both the surgeon and the patient. 
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Nasal grafts

If the bridge of the nose is flat or low, then a cartilage graft can be used to augment this area.  There are always limitations to how large a graft can be put in becuae of the skin envelope.  A rib graft is usually best if a large graft is needed.
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Graft to nose

Hi, rib graft can certainly be used to augment the bridge of the nose. We also use the septum and sometimes cartilage from the ear. You can go larger, but keep in mind that your skin will only tolerate so much underneath, so there is a limit to how large you can go in that sense. In some cases, the nasal tip is very large in relation to the rest of the nose, and this makes the dorsum of the nose seem small. In that case, you might just need to have the tip reduced. in any case, you... more
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Rib grafts for dorsal augmentation.

Cartilage grafts are often used to rebuild the nasal bridge in cases in which too much was was taken during a previous surgery. Although rib cartilage may be required, most surgeons use this in cases in which other sources of cartilage (septum or ear) are not available. If it is needed, it can be an excellent choice, however, the surgeon must be experienced in order to prevent potential complications.
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Rib graft is the most aggressive option, but is necessary sometimes

Cartilage grafting is the best way to augment the nose. It is the least likely to have infection and rejection issues. The progression of cartilage grafting is usually nasal septum, ear cartilage, then rib cartilage. Septal cartilage is the most accessible but often is limited in quantity. Significant nasal bridge augmentation may require more than what the septum can offer. Ear cartilage offers more but the bend in ear cartilage makes it less attractive for the nasal bridge but can be... more
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Rib cartilage graft is a good option

I agree with some of the comments from the other surgeons that a rib graft could be used in the absence of sufficient septal cartilage. The rib cartilage will provide more than enough tissue for enlarging your nose and provide support that is not achievable with other grafts such as ear cartilage. Your surgeon does need to be experienced with this procedure in order to achieve a good result. The limitation in making your nose larger is the skin of your nose; one does not want to stretch... more
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Rib Grafting

Yes, a rib graft can provide autologous (your own) support and contour enhancement to your nose. I use rib grafts when local resources are either depleted or their harvest would destailize the infrastructure of the nose. I prefer nasal septal cartilage but in many of the revisions I perform, the septal cartilage has already been used. I therefore typically move to the ear as a source, unless the ear cartilage is not adequate. My advice is to find a board certified Plastic surgeon with... more
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Rib Graft to Enlarge Nasal Bridge

The nasal bridge (a.k.a. dorsum) can be augmented with cartilage. Most commonly, this cartilage can be harvested from the nasal septum or the ears. If more cartilage is required or these sources are depleted, rib cartilage is the next (last) source. Some surgeons like bone (i.e. from the skull) or cadaver cartilage. Artificial materials can be used (Goretex, silicone) but I usually recommend avoiding these non-biologic materials in the nose.
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I agree with the other surgeons.

 There is rare need for  a rib graft. You can make the nose much larger using septal and ear cartilage grafts along with soft tissue.
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I use rib grafts rarely because...

Rib grafts should be used only as a last resort by only truly skilled and experienced rhinoplastic surgeons. The problems with rib grafts include significant discomfort following surgery and most importantly it is difficult to predict long term absorption. Another significant concern with rib grafts is the tendency to "warp" or reassume natural curvature. I prefer septal or ear cartilage as a first opition and Gore-Tex as a seond option. None of the above apply in our 20 year... more
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Rib or bone grafts to the nasal bridge (nose job or rhinoplasty)

Yes rib grafts are commonly used to augment the nasal bridge. Traditionally this is rib cartilage. Less often, the hip bone (iliac crest) or skull (calvarium) can also be used for recontruction of the bridge.
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Rib grafts to the nose

Although a rib graft is an acceptable form of reconstruction of the bridge of the nose, you should seek out a board certified plastic or facial plastic surgeon with experience in such reconstructions as it can be very demanding and he/she must be quite artistic. Plastic surgeons who do craniofacial surgery should be quite skilled at this. There are alternatives to rib grafting including cartilage, dermis, fascial grafts, and it depends on the size and depth of the defect. Again, you need... more
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