I have an extremly flat face and nose and had a surgery 3 years ago using my rib cartilage which was almost completely dissolved except the tip and 2 week ago i had another one using MEDPOR removing my previous tip but m unhappy with the shape and also i dont like foreign bodies inside me,if i m not gonna get my shape i dont think i shld continue for a minimal change amlost unnoticable want to remove it and redo a indegenous one using my RIB cartilage.will it last or dissolve?prominent tip desird
Rib Cartlage Dissolved, Is it Worth Trying Rib Cartilage Again? (photo)
Doctor Answers (5)
Worth Trying Rib Cartilage Again?
With rib cartilage grafts it is very important to fix the grafts in place to reduce warping or absorption. There will likely not be enough ear or septal cartilage avalable to augment your bridge.
In my experience you will not be able to get enough cartilage from your ears or nose to give you the amount of bridge augmentation that you need. You say the previous rib procedure gave you enough volume temporarily. I suspect there was some bone in that graft and it was not pinned to the underlying native nasal bone so it resorbed. Your medpor implant did not give you enough volume but you should realize that there is more than one model/style of medpor implant. The lack of sufficient bridge afterward could be a result of using the wrong model/type rather than the problem just being medpor was used. I suspect you will also need more augmentation in the upper half of the bridge than in the lower half of the bridge.
You obviously agree that further surgery is required and you should get copies of the previous surgery operative reports to bring with you to consultations with prospective surgeons.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Rib cartilage failure for the Asian nose.
Rib cartilage failure for the Asian nose happens. I would do a revision rhinoplasty with your ear or septal cartilage which has given good results in the past 35 years that I have used it.
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Rib Cartlage Dissolved, Is it Worth Trying Rib Cartilage Again?
Nope, not in my opinion. This is why I don't use rib cartilage/bone for building up the nasal bridge. Straight, silastic dorsal implants are more reliable IMHO.
Rib Graft Resorption in Rhinoplasty
It is extremely rare in my experience to have your own rib graft resorb when placed for a dorsal augmentation rhinoplasty. It may have done this if the rib graft was mainly bone and not cartilage. Your concern about resorption with another rib graft is understandable. It may be less likely to happen the second time around as the tension on the rib graft may be less due to having an indwelling implant which has maintained a pocket for the new graft.
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.