Revision Rhinoplasty Q&A
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Where does the cartilage come from for a rhinoplasty revision for a pinched tip?
asked 10 months ago by anon
Latest answer by Rod J. Rohrich, MD
Question viewed 420 times
Tags: nose, nose tip, cartilage, pinched, revision, surgery
My wife wants a rhinoplasty revision for a pinched tip; how is it possible to add back what was once taken away? Where does the extra cartilage come from?
15 answers to Where does the cartilage come from for a rhinoplasty revision for a pinched tip?
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The Pinched Secondary Rhinoplasty Look
Having a pinched nasal tip is very common especially in patients who have rhinoplasty done in the 70’s and 80’s and still some done in some parts of the world where cartilage is excessively moved or transected. The optimal management for this is to find a highly experienced rhinoplasty surgeon that can reconstruct using your own tissue either from your own septum or ear cartilage. Using your own tissue is the best and in most cases this will require reconstruction of the nasal...
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Revision of rhinoplasty complications often requires additional cartilage from the nose, possibly the ear or rib cartilage
Revision of rhinoplasty complications often requires additional cartilage from the nose, possibly the ear or rib cartilage. Most often, if enough cartilge is left in the nasal septum, that will be used. The second most common source would be cartilage from the "bowl" of the ear. A small incision is hidden on the back of the ear and this does not change the appearance of your ear. If alot of cartilage is required or the previous two sources do not provide enough cartilage, then a...
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Usually from the ear but may require rib cartilage if issue is significant
Yes, i call it "reverse rhinoplasty" we usually use ear cartilage but may require rib cartilage if the issue is significant.
see video
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Rhinoplasty revision donor cartilage.
For 35 years of revision rhinoplasty I have never had to use rib. The septum and ears can supply all the cartilage one needs except for total nasal collapse. See an experienced rhinoplasty revision surgeon.
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Revision for pinched tip
The pinched tip look is a tell-tale of a poorly performed rhinoplasty. Supporting the tip in this case requires grafting and the best material is autologous cartilage. Possible harvest sites include the nasal septum, the ear, or the rib. I generally use ear cartilage, but rib may be necessary if the nose is very tight and needs the sturdiest support. Make sure your surgeon has experience with tertiary rhinoplasty.
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Where does cartilage come from
If not totally depleted from the first surgery the "new" cartilage to be added usually comes from the nasal septum. If there is not enough available from the septum I will usually go to the ear as my "spare parts box" for the nose. If unusually large amounts or major support is needed or the ears have already been used then I would go to the patients rib. Another option is donor irradiated rib but it would be my last choice.
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Where do cartilage grafts come from for revision rhinoplasty surgery?
The cartilage to rebuild a pinched tip comes from either the nasal septum (the dividing wall inside the nasal cavity) -- if there is some available -- or from ear or rib cartilage. Ear cartilage is taken from what is called the conchal bowl via an incision behind the ear. The skin of the ear is left in place (so there's no hole in the ear) and the ear typically heals very nicely with no visible change to its shape. If more support is needed rib cartilage is a great option.
Visiting...
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Cartilage Graft For a Secondary Rhinoplasty
The cartilage used for grafting in a secondary rhinoplasty is either taken from excess cartilage remaining in the nose itself or else it is taken from the ear. It is done through an incision behind the ear, which is very well concealed.
Gary D. Breslow, MD
Paramus Plastic Surgeon
Paramus Plastic Surgeon
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Where the Cartilage used in Rhinoplast comes from
The cartilage used for grafting during a rhinoplasty comes from the septum, ear or rib cage. If possible the cartilage will come from the septum as no additional scars are necessary.
The septum is the wal that divides the right and left nostril. The lining over the cartilage is lifted off, the needed cartilage is taken and then the linings are sewn back together. If the septum doesn't have enough cartilage, then the cartilage is taken from the bowl of the ear or the ribs right next...
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Benjamin Dunkley, DO
Salt Lake City Facial Plastic Surgeon
Salt Lake City Facial Plastic Surgeon
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Best cartilage for revision rhinoplasty
The best cartilage to use in revision after rhinoplasty is from the septum up inside the nose. If the septum does not have enough available the cartilage from the ear is readily available and gives very good results. If the nose needs even greater support rib cartilage can be used as well.
Best of luck,
peterejohnsonmd
Peter E. Johnson, MD
Chicago Plastic Surgeon
Chicago Plastic Surgeon
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Sites for Cartilage Grafting
In Rhinoplasty, the Surgeon will generally want to "do the least to accomplish the most". Therefore, the easiest area to harvest cartilage from is the nasal septum, followed by ear cartilage, and sometimes even rib cartilage. Septal cartilage is not always available in revision Rhinoplasty circumstances. Although ear cartilage is often acceptable, it is limited in supply and certain cases require larger pieces of cartilage. The down side of rib cartilage is donor...
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Cartilage harvesting for revision rhinoplasty
It is possible to add back cartilage by harvesting it from another site and replacing it in the nasal tip to change the shape or add support. Cartilage is most commonly harvested from the nasal septum, the ear, or the rib. This can be done at the same time as the nasal surgery. Using the patient's own cartilage minimizes the chance for rejection of the material and potential complications postop. This is commonly done with revision rhinoplasty when cartilage has...
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Kristin Egan, MD
Manhattan Beach Facial Plastic Surgeon
Manhattan Beach Facial Plastic Surgeon
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Cartilage donor sites for revision rhinoplasty
Cartilage can be taken from the septum inside the nose, the ear, or rib. Usually the rib is for more work on the dorsum of the nose, whereas the other sites are good for the tip due to the thickness of the donor cartilage. usually there is no residual deformity to either area. the ear cartilage is taken with a scar behind the ear which heals we..
Rick Rosen, MD
Norwalk Plastic Surgeon
Norwalk Plastic Surgeon
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Revision Rhinoplasty Cartilage Sources
In some revision rhinoplasty cases cartilage needs to be added to the nose for support and/or looks. Correcting a pinched tip may be one such example. We generally get extra cartilage from the following places (in order of ease and general preference): Septum, ears, patient's own rib cartilage, and cadaveric rib cartilage. Hope this help out and all the best, Dr. Vartanian
A. John Vartanian, MD
Glendale Facial Plastic Surgeon
Glendale Facial Plastic Surgeon
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Where does the cartilage come from for a rhinoplasty revision for a pinched tip?
The most common site where we obtain cartilage graft would be the nasal septum. If it is not available we would use ear cartilage and if larger and or stiffer cartilage are required we use rib cartilage grafts.
Peter A Aldea, MD
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