How likely is this? Does it all depend on the patient’s nose/scar tissue/etc.? I’m hoping for a revision to give my nose back its tip and length and I am a little nervous for the possibility of the cartilage shrinking or the rib warping (if I’d need rib). And if anyone has experience with this please let me know.
Answer: Rib grafting for revision rhinoplasty Rib cartilage is the ideal source for obtaining additional cartilage to strengthen the underlying nasal structure when septum is no longer available or insufficient in quantity. Ear cartilage is also an option. Rib cartilage warps very little over time and seems to occur in about 1.5 to 2% of all rhinoplasties where this type of graft is used. Good technique is important as well as proper placement. I personally have not had any patients warp their cartilage over time.
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Answer: Rib grafting for revision rhinoplasty Rib cartilage is the ideal source for obtaining additional cartilage to strengthen the underlying nasal structure when septum is no longer available or insufficient in quantity. Ear cartilage is also an option. Rib cartilage warps very little over time and seems to occur in about 1.5 to 2% of all rhinoplasties where this type of graft is used. Good technique is important as well as proper placement. I personally have not had any patients warp their cartilage over time.
Helpful 3 people found this helpful
July 8, 2018
Answer: How likely is rib cartilage warping or shrinkage? Cartilage grafts are the ideal grafting material. They do need to revascularize, and it is extremely rare to see shrinkage if taken from the patient's own rib. Warping can be minimized with proper technique but hard to completely eliminate in all cases. For a variety of reasons including warping, wrapping finely diced cartilage in a fascia wrap offers advantages in many cases.
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July 8, 2018
Answer: How likely is rib cartilage warping or shrinkage? Cartilage grafts are the ideal grafting material. They do need to revascularize, and it is extremely rare to see shrinkage if taken from the patient's own rib. Warping can be minimized with proper technique but hard to completely eliminate in all cases. For a variety of reasons including warping, wrapping finely diced cartilage in a fascia wrap offers advantages in many cases.
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Answer: Rib cartilage I'll try to clarifiy concepts I think may be of the greatest help for you and readers: -rib cartilage is an excellen kind of graft, has no substitute whenever the surgeon needs thick, strong or long grafts or when other donor sites are for whatsoever reasons unavailable; however it is not the first choice in structure and revision rhinoplasties in the vast majority of cases (its morbidity involves a visible scar at the chest a a somehow painful couple of weeks after surgery, besides the time consuming procedure to harvest it and the technical skills required) -in afroamerican and asian rhinoplasties of primary type rib cartilage is required in 90% of cases; in revision rhinoplasties (non ethnic) the percentage of rib cartilage usage is way smaller, I'd rate it 20-30% cases -genuine or predominantly african and asian noses the use of rib can be cosidered the rule, so in your case it was good decision -harvesting a rib cartilage is technically challenging, the surgeon has to be careful not to produce a pneumothorax or a pleural tear, and its tayloring is tricky: only the core, center or shaft of the rib cartilage is usable, since it is the straight part which remains straight, the cortex of the rib cartilage warps and has to be discarded as first instance (although there are trick to use it like joining 2 warped cortex portions facing each other like parenthesis); as a rule and regarding the build up of a dorsum in afroamericans or asians, or saddle nose deformities in revisions, the shaft of the cartilage is the block we shape and taylor for the nose; failing to use ONLY the shaft leads to warping, this is a well known fact many decades ago and still some surgeons fail to comply with this technical standardSeek the advice and hands of a serious professional who offers to you a time-consuming and expensive procedure; stay far from minimally invassive snake-charming procedures, synthetic implants, fillers, wrapped diced cartilage, etc. See the link below to find few cases of my own practice very similar to yours which I had the opportunity to operate successfully on, sharing a lot of common features with the technical problem you have posted. If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also from underneath.
Helpful 11 people found this helpful
Answer: Rib cartilage I'll try to clarifiy concepts I think may be of the greatest help for you and readers: -rib cartilage is an excellen kind of graft, has no substitute whenever the surgeon needs thick, strong or long grafts or when other donor sites are for whatsoever reasons unavailable; however it is not the first choice in structure and revision rhinoplasties in the vast majority of cases (its morbidity involves a visible scar at the chest a a somehow painful couple of weeks after surgery, besides the time consuming procedure to harvest it and the technical skills required) -in afroamerican and asian rhinoplasties of primary type rib cartilage is required in 90% of cases; in revision rhinoplasties (non ethnic) the percentage of rib cartilage usage is way smaller, I'd rate it 20-30% cases -genuine or predominantly african and asian noses the use of rib can be cosidered the rule, so in your case it was good decision -harvesting a rib cartilage is technically challenging, the surgeon has to be careful not to produce a pneumothorax or a pleural tear, and its tayloring is tricky: only the core, center or shaft of the rib cartilage is usable, since it is the straight part which remains straight, the cortex of the rib cartilage warps and has to be discarded as first instance (although there are trick to use it like joining 2 warped cortex portions facing each other like parenthesis); as a rule and regarding the build up of a dorsum in afroamericans or asians, or saddle nose deformities in revisions, the shaft of the cartilage is the block we shape and taylor for the nose; failing to use ONLY the shaft leads to warping, this is a well known fact many decades ago and still some surgeons fail to comply with this technical standardSeek the advice and hands of a serious professional who offers to you a time-consuming and expensive procedure; stay far from minimally invassive snake-charming procedures, synthetic implants, fillers, wrapped diced cartilage, etc. See the link below to find few cases of my own practice very similar to yours which I had the opportunity to operate successfully on, sharing a lot of common features with the technical problem you have posted. If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also from underneath.
Helpful 11 people found this helpful
July 8, 2018
Answer: Cartilage Warping There is always the possibility of cartilage warping, but there are several ways to control and reduce the chances of this happening. This has to do with the way the cartilage is is cut and fashioned, and how the grafts are placed at the time of the procedure. Choosing a plastic surgeon who has experience and expertise in revision rhinoplasty is also extremely important because he or she will understand all of the nuance when it comes to preventing cartilage warping.
Helpful 2 people found this helpful
July 8, 2018
Answer: Cartilage Warping There is always the possibility of cartilage warping, but there are several ways to control and reduce the chances of this happening. This has to do with the way the cartilage is is cut and fashioned, and how the grafts are placed at the time of the procedure. Choosing a plastic surgeon who has experience and expertise in revision rhinoplasty is also extremely important because he or she will understand all of the nuance when it comes to preventing cartilage warping.
Helpful 2 people found this helpful