Once healed and settled the rib will last forever
There is a small risk of warping or bending in the first week but this is minimised if a surgeon is experienced in handling rib cartilage
Each surgeon develops experience with grafting to the nose, and bases his or or her techniques on what works best for them and yes, long term followup from other experiences. While a standard exists for using silicone wrapped in fascia or dermal grafts, on asian noses, and is taught in courses, yet other experts continue to rely on nasal cartilage which can be stiff and create tension in a few cases. This is usually for secondary and complex noses where no bridge is present preoperatively. Other less tension options include dermal grafts alone which can melt away in some cases, or our thinking is the use of ear plus or minus septal cartilage with a fascia wrap. For speed and efficiency some practices prefer silicone and some form of wrap. We do like ear cartilage and a wrap, as it lasts a lifetime, but from time to time minor adjustments and trims may be necessary. The primary nose, or in fact the primary asian nose with a flat bridge, should be treated with natural bendable ear and or septal cartilage and gently configured so that sharp edges do not appear early or late in the course. Follow the course with your surgeon. The rib cartilage might need a trim or adjustment if it does not settle and mold into place. Our practice does not prefer any silicone or plastic materials for the nose.
There are a number of techniques available to reshape and build up the bridge of the nose during Asian rhinoplasty. Synthetic implants such as silicone implants carry a higher risk of complications (including infection, migration, and extrusion) than grafts made from your own tissue (autologous grafts). In general they produce aesthetic results which appear less natural than an expertly placed autologous graft, and do not produce a permanent result. Without question, using rib cartilage will be the best option to achieve maximal projection and refinement of your nose.
Especially when building up the nose a significant amount, using synthetic implants will put excess tension and stress on the skin, ultimately thinning it and causing issues down the road.
Thank you very much for sharing your concerns with us.
The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.
In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.
Dr. Emmanuel Mallol Cotes.-