Rib or Ear Cartiledge to Increase Nose Bridge Height and Tip?

Generally the ear cartillage is 2-3 mm thick and a double layer will only accomplish 4-6mm of augmentation. Therefore other techniques have been developed to increase the augmentation by rolling it or dicing and placing it within an absorbable sleeve.
The rib cartilage can easily be 10 mm in thickness and can accomplish a greater enalrgement for the bridge but is less generally less preferable for the tip.
The septum is the ideal choice for the nose, especially the tip but occasionally does not provide adequate material for the bridge.

Warping is actually less with ear cartilage but ear cartilage has a higher rate of reabsorption. Increasing bridge height is best done with a rib graft. In order to decrease chances of warping, a technique called concentric carving is utilized. This means that the outer layers of the rib are carved down, leaving the central part of the rib for use as a graft. This has been found to markedly decrease the rate of warping when using rib. One of the challenges with using septal and ear cartilage for bridge augmentation is that there is usually not a sufficient amount to provide one long segment over the bridge. You then end up using several different fragments of cartilage jointed together, which is a piecemeal approach. In my opinion, this is a suboptimal approach compared to using one continuous segment of concentrically carved rib cartilage. With regard to pain, ear cartilage harvesting does hurt but typically is not as bad as the pain associated with rib harvesting. There is definitely a tradeoff between the two procedures. In either case, pain is usually well controlled with low dose narcotic medication and subsides within the first week.