Revision Rhinoplasty: Q&A
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Rib Cartilage Used As Spreader Grafts - How Likely Are the Complications?
Hi, I am considering a revision rhinoplasty because I have an inverted V deformity and it hurts my breathing. Two surgeons I have consulted have said that I don't have enough septal cartilage remaining, and that the ear cartilage is not strong enough so they want to use rib cartilage. I was wondering how successful rib cartilage spreader grafts have been and the potential complications. Thanks
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9 Doctor Answers |
Asked by
Sisi87
in USA
+3
Rib grafts are often the foundation for a revision rhinoplasty
That bold statement is my personal observation after performing several hundred rib graft revision rhinoplasties. I find the strong straight pieces of rib to be excellent for rebuilding the bridge of the nose that has collapsed and formed an inverted "V" deformity after a rhinoplasty. We rarely see complications with the use of rib grafting. On a female the scar is nearly invisible as we place it in the same location as plastic surgeons use to place breast implants. The biggest...
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Rib cartilage for spreaders
Rib is a great source of cartilage for spreader grafts when septal cartilage is not available - ear cartilage is OK for correction of a contour deformity but lacks enough strength to correct a significant inverted V
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Donor Irradiated Rib Cartilage
Irradiated rib cartilage is procured from expired human donors and is irradiated to remove any causes for disease transmission or tissue rejection. Recently a long-term, landmark study was published describing the excellent reliability and consistency of irradiated rib grafts for patients who do not have enough septal cartilage and do not want to use their own ribs (see abstract link below).
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Complications of rib cartilage grafts
The inverted V deformity can be addressed through multiple techniques such as spreader grafts and osteotomies. It is better to have ear cartilage used as spreader grafts since there is much less trauma and complications that can occur with rib. Rib cartilage will tend to warp over time and make the nose very stiff. Another potential complication with a rib graft is the possibility of collapsing a lung when the cartilage is harvested from the ribs, in which case the patient will require a...
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Rib cartilage and spreader grafts for revision
If you are having a revision rhinoplasty and you do not have enough septal cartilage to work with, rib cartilage is certainly a reasonable substitute. There are also other choices like irradiated cartilage which is from a cadaver, or now a PDS product used for this procedure.
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Using rib cartilage for revision rhinoplasty
Rib cartilage is a viable source of excellent cartilage for performing revision rhinoplasty.
Ear cartilage can be used as well, but ear cartilage is limited in how long of a spreader graft that can be made. Depending on how thick your spreader grafts would need to be, there may also be limits to how thick ear cartilage-based spreaders grafts can be made. The cartilage can be sandwiched to widened the graft. To get enough cartilage both ears may need to be harvested. With rib there is...
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Rib cartilage graft
Any surgery has it own set of complications and risks.
Harvesting the rib cartilage graft has a small risk of entering the chest and a collapsed lung, which require a chest tube at worse.
Warling can be prevented by taking the graft frm the middle of the cartilage block, less warping forces.
Consult a BOARD CERTIFIED PLASTIC SURGEON ( AMERICAN BOARD OF PLASTIC SURGERY), THEY KNOW HOW TO HARVEST THE GRAFT
Baltimore Plastic Surgeon
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Use of rib cartilage as spreader grafts for revision rhinoplasty
The primary problem with the rib cartilage will be preventing it from warping. Otherwise it is an ecellent material to use in the nose. The list of complications are the same as any other nasal procedure plus the risks of graft resorption and the ptoential donor site complications.
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Rib cartilage works great!
I would have few concerns about using rib cartilage for your revision rhinoplasty surgery, assuming you are healthy and have few medical problems. The rib offers an area where an abundant amount of cartilage can be found and offers few side effects. The potential complications from rib grafting include bowing of the cartilage and infection, but these risks are very unlikely. Another quite unlikely, but serious complication, from rib grafting is a collapsed lung. ...
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