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Is Rib Cartilage the Best Option for Rhinoplasty Given a History of Capsular Contracture? (photo)

I would like to increase the height of my bridge and to make my tip more refined. I have gotten capsular contracture twice with my breast implants so I'm afraid my nose would reject silicone or goretex. The photos are of me currently (I had restylane injected 6 months ago and still not completely gone, so my bridge is originally lower). Would rib cartilage be the best option to increase the height of my bridge? Also do I need an alar base reduction and osteotomy to make my nose slimmer?

Doctor Answers (8)

Healing After Rhinoplasty With Someone Who Had Capsular Contracture

+1

Hello,

There is no correlation with developing capsular contracture and having issues with nasal implants.

As for choosing between an autologous cartilage grafts and a silastic implants depends on the surgeon's skills. In other words, the details can be discussed during an in-person evacuation to plan the solution on solid bases.

I hope this helps.

Thank you for your inquiry.

The best of luck to you.

Dr. Sajjadian


Orange County Plastic Surgeon
5.0 out of 5 stars 125 reviews

Rhino Grafting

+1

Focus on the task at hand (your nose).  You have many fine options for nasal dorsal augmentation as listed below.  Discuss the pros and cons for each type of implant with your Cosmetic Surgeon know that each and every surgery has its own set of healing issues.

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Rib Cartilage for Rhinoplasty Augmentation

+1

There is no connection between breast and nasal healing. Don't be concerned about your previous unfortunate experience with breast augmentation. I prefer to use cartilage from the  septum or the ears to augment the nasal bridge. It is readily available and easier to harvest  than the ribs. You will need osteotomies to narrow the bridge. I would also narrow your asymmetrical alar base.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

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Rib graft or plastic material for higher nasal profile

+1

Hi there,

As you've seen from the answers below, there are a variety of choices to make.

What is certain is that a graft of some type is necessary to refine your nose and elevate the bridge.  The graft options are either taken from you (septum, ear, rib or fascial based), or are types of biocompatible plastic (silastic, medpor).

Each of them has their risks and benefits, each surgeon comes to prefer the one they work best with, and they all work. Some are simple with a quick recovery, and some more complex.

The important thing to understand though is this:  The days of just putting a graft in and doing nothing else are gone.  That is, patients today have more specific aesthetic concerns, and many desire a more nuanced result than just their old nose with a higher bridge. Patient expectations are increasing due to the ready availability of detailed information on the internet , and the surgeons ability to deliver on them, is improving.

So the best thing to do is to have a proper consultation with an experienced rhinoplasty surgeon and discuss your aims.  They can advise and explain to you the pros and cons of the choices.  Really, what you want is the nose you'd like... not a graft specifically, but a result and your outcomes achieved.  The graft is just one of the tools used in order to achieve that.

As others have said, your capsular contracture problem isn't relevant to your nose, although it's insightful of you to mention it.

Good luck.

 

Howard Webster, MBBS, FRACS
Melbourne Plastic Surgeon
5.0 out of 5 stars 63 reviews

Asian rhinoplasty

+1

Silastic implants are simple to place and long lasting if placed in the right pocket. Patients have had this for over 20 years or more, but I do also have shoe boxes full those that I have removed because they were not placed in the proper place. Rib cartilage has its own complications and not necessary for your type of nose. Crushed cartilage wrapped in fascia is another way of doing this. The latter is more time consuming, expensive and involves more surgery. Good luck

Mohsen Tavoussi, MD, DO
Huntington Beach Facial Plastic Surgeon
4.5 out of 5 stars 9 reviews

Bridge Augmentation

+1

Hi,

Breast implants and nasal implants are NOT the same. A good custom carved silastic nasal implant is the best option for this. There are several recent scientific articles proving this. I have done hundreds of custom carved silicone implants for bridge elevation without any problems. You can see many examples of this on my website.

Best,

Dr.S.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
5.0 out of 5 stars 215 reviews

Rib Cartilage Would Be The Last Option To Build The Nasal Profile

+1

Ethnic rhinoplasty require an in depth conversation between the patient and doctor in order to get the best result.  I will give you my opinion what would be best from my experience.  There are certainly a few different ways to get you a softer nose.

The breast and nose entirely different areas and there in no know increased risk for capsular contracture in the nose that I know about.

In order to give you a stronger profile, you need either cartilage or an implant.  If at all possible, I try to use the patients own natural cartilage because:

1)  Decreased risk of infection

2)  Decreased risk of extrusion to patient

3)  Maybe more affordable to patient

 

In your case I would use the cartilage in your nose, septal cartilage, and possibly cartilage from your ear to build up the dorsum.  Occasionally, I will also use fascia from a small incision in your hair to help build up the area.  I only use rib cartilage in patients that do not have cartilage in their nose/ears or require a reconstructive procedure. 

If you are concerned about the width of your nostrils, an alar base reduction would be appropriate.

 

I hope this helps!

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Connection capsular contracture and rib cartilag

+1

No scientific connection in healing  between nose and breast just bad luck if both complications occur...I believe crushed cartilage   ear or rib is best for elevation of the profile not rib graft..It is a softer more natural contour.

Richard Ellenbogen, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.