Advantages of Ear Cartilage for Asian Bridge Job?

Ear cartilage is soft, pliable and easily harvested through an incision that is well-hidden in the crease behind your ear.  It will not change the shape or size of your ear.  Using your own cartilage is much safer than using a synthetic implant, and will give you a much longer-lasting result.  

Ear cartilage has a few benefits compared with other sources of material. Compared with silicone implants your own cartilage, in general, has a better safety and longevity profile. Compared with rib cartilage, the incision for ear cartilage is easily hidden behind the ear.

One downside with using ear versus rib cartilage is that in some patients there isn't enough ear cartilage available for fully augmenting the bridge. Ear cartilage is also softer than septal or rib cartilage so may not prove as helpful in improving tip definition. With my current carving and graft placement technique I have not found cartilage warping to be an issue in my practice.

Augmentation of the radix (the bridge of the nose) can be performed safely with cartilage or a silicone implant.

The advantage of using cartilage is that it is your own tissue, and therefore less likely to become infected, or extrude (erode through the skin or into the nose).  The disadvantages of using cartilage are that it can warp or resorb.

When using cartilage your surgeon can increase the chances for success by use of a symmetric design and letting the cartilage set for a period of time after the harvest.   

I recommend finding a Board Certified Plastic Surgeon who performs rhinoplasty regularly to discuss this further.

Best,

Jeremiah Redstone, MD

The autogenous cartilage used in the nose formation is not only the ear cartilage but also the septum cartilage and the costal cartilage. Among them, the ear cartilage is the most commonly used cartilage together with the septum cartilage. The advantage is that it is soft and thick, has a more natural shape than the septum cartilage, and is mainly used on the tip of the nose than the bridge. The nasal septum is the most commonly used cartilage in recent years. It is a cartilage placed in the pillar of both nostrils and serves as a support. Therefore, It has the advantage that it can be taken without further incisions and scars during molding.

Ear cartilage has a low donor site related problems, low infection and resorption rates, and easily carved. However, there is often an insufficient amount of ear cartilage when you need to significantly augment the nose bridge.

I prefer to use rib cartilage for dorsal augmentation.  Ear cartilage is not sufficient for most cases and it is a softer cartilage.

Silicone nasal implants for the nasal bridge have been used extensively particularly in Asia.  I've used them for many years and they usually work very well. Only rarely do they get infected as long as they're not used to augment the tip as well.  They are often a bit mobile; can be asymmetric; and sometimes the edges can be felt.  Cartilage from the ear is a good alternative. If I use ear cartilage I prefer to dice it (cut it into very small pieces that I then inject into a carefully prepared tunnel using a syringe).  My patients and I have been happy with this method. The advantage of using your own cartilage is that compared to silicone, late infection and loss of the graft is very unlikely. With the diced cartilage method, unlike traditional methods, warping and asymmetry of the graft is not a concern. 

 

From my perspective ear cartilage is contra-indicated in bridge work either with Asians or any other ethnic group. Ear cartilage in the bridge area either shrinks and becomes unsightly or dissappears altogether. You need a homograft of either skull bone or rib bone. 

 

  I have performed Rhinoplasty, including Asian Rhinoplasty, for well over 20 years and IMHO...there are no advantages, only disadvantages in using ear cartilage to build up the nasal bridge.  Ear cartilage is curved and as such must be folded to create a straighter graft shape for placement on the nasl bridge.  This is never, IMO, as straight as a straight silastic dorsal graft which is what I prefer for building up the nasal bridge.  Ear cartilage, IMHO, dissolves unevenly over years making it a undesirable dorsal grafting material.  

 IMO rib cartilage and bone is also susceptible to dissolving unevenly over years and I do not use this material for building up nasal bridges for this reason.  Be sure that your Rhinoplasty Surgeon understands and follows the proper aesthetics of facial (and nasal) beauty for the creation of a naturally, more attractive nose.