Possible Ear Cartilage Warping from Rhinoplasty?

Ear and septal cartilage are actually two different types of cartilage (elastic and hyaline, respectively) and have different mechanical properties. While any cartilage graft can warp (twist or deform over time), septal cartilage tends to be more useful structurally. You're also correct that most surgeon's--myself included--will use septal cartilage over ear cartilage, if it's available. Most patients undergoing their first (and hopefully last) rhinoplasty will have adequate septal cartilage available.
I'd be a bit suspicious of someone advocating ear cartilage first (unless the septal cartilage was too deformed, or had a large perforation). It makes me wonder if the surgeon is experienced at operating on the septum. And if he/she isn't, then that surgeon shouldn't be touching the rest of the nose!
All the best,
--DCP

Frank-
Ear cartilage is higly specialized, thin deformable cartilage that is used all the time for nasal surgery, mainly in reconstruction, and primarily in areas where fine-tuning needs to be performed. Warping occurs as the scars heal and contract over time...these forces can uncontrollably deform the cartilage and twist the results.
I am a big fan of ear cartilage in very specific circumstances or when other sources are not readily available, i.e. septal cartilage from inside the nose. Septal cartilage is very rigid and resists deformation over time better than ear cartilage. Again, both are great options in very specific indications. For tip elevation and a tip-plasty, I typically use septal cartilage if it is available. If it is not and we need structurally rigid support, I then move to rib cartilage.
Make sure you excert all your options and see as many Board Certified surgeons as you can to gather as much information as you can with regard to your particular case.
I hope this helps!
Good Luck-
Dr. C

You have asked some interesting questions. "Warping" is when the cartilage implant bends, or changes shape. This may happen to cartilage implants, but is not usually a problem with the strut you have described.
Ear cartilage is not very straight to begin with--so it's not my first choice for a tip strut. I prefer to use septal cartilage--which is generally much straighter. You mentioned that you had never had a rhinoplasty--but have you had a septoplasty--was cartilage removed from your septum? If so, this may be why the surgeon wants to use ear cartilage. If not, ask if the surgeon can use your septum as the donor for the cartilage.

Cartilage warping after rhinoplasty can occur and may not even be visible until many years after the procedure. The absolute best cartilage for rhinoplasty surgery is your own septal cartilage if it is available. Septal cartilage rarely if ever warps and is always in my opinion the best and should be the first choice. Now if you have had septal surgery before that cartilage may not be available; however, if you have not I would recommend that cartilage be the first choice. You should discuss with your surgeon why he does not wish to use septal cartilage and especially if the purpose is to lift your tip since septal cartilage is inherently straighter, longer, stronger and generally does not warp. I hope this information helps.

Dear Frank,
Ear cartilage is not typically used if you have never had rhinoplasty. It doesn't have the same support as septal cartilage and has a greater chance of warping. It will also leave an unnecessary scar on your ear.
I do use ear cartilage grafts in revision rhinoplasty when there is insufficient septal cartilage or if I am reconstructing missing convexly-shaped portions of the tip that have been over resected.
Ask your plastic surgeon for his rationale.
Good luck!

If you've never had a previous rhinoplasty, I'm not sure why your surgeon is suggesting the use of ear cartilage. Septal cartilage is stronger, straighter, easier to harvest, and won't leave a scar on your ear.
If your surgeon is experienced, you'll get a good answer. If not, please get a second opinion.
I've attached a link to my rhinoplasty photos for your perusal. Just about all of my Rhinoplasty patients have septal cartilage grafts (Columella-struts), since they work well in helping to support and rotate your tip.
I hope this is helpful, and best regards.

There are a number of choices for cartilage grafts for the nose. My preference is septal cartilage. It tends to be stronger and straighter than ear cartilage. They are actually different kinds of cartilage. Not only is ear cartilage weaker, but just look at your ear, the cartilage is already inherently curved, so getting a straight piece is much harder. I cannot judge the surgeon you chose, but someone should be comfortable with all aspects of nasal surgery to do the best rhinoplasties.

Hi Frank,
You are correct. Nasal septal cartilage is preferred to ear cartilage for nasal grafts because it is structurally stronger cartilage and much less likely to warp (bend its shape).
It is most unusual for a rhinoplasty surgeon to take ear cartilage when "virgin" septal cartilage is available. Why create another surgical site when the cartilage can be taken from inside your nose? I guess these are questions that you need to address with your rhinoplasty surgeon.
Good luck and be well.
Dr. P

All sources of cartilage in the body can warp or twist with time-- some plastic surgeons even try to support the cartilage by inserting a stainless steel wire through the cartilage first as an added support, and have had excellent results with this technique (It looks like you're from Texas, and I believe this is done by some of the surgeons at UT Southwestern in Dallas).
Some folks believe ear cartilage is less likely to warp, others disagree, so it does come down to the surgeon's choice-- find someone you're comfortable with, seek out more than one opinion as well, and maybe even speak to the folks in Dallas if this is not too inconvenient.
Good luck,
Dr. S

Cartilage warping occurs when a piece of shapede cartilage becomes distorted or deformed. This is possible at any time and can effect any caritlage. Septal cartilage tends to be the first choice and I would ask your surgeon for the rationale in choosing ear cartilage.