Costal Cartilage Graft Overtime?

Dear RBrownBH, The perfect graft in revision Rhinoplasty would be completely risk free, have no complications, be easy to harvest, and offer predictable results.  Costal cartilage grafts are generally used when a large amount of cartilage is required for grafting and/or there is insufficient alternative sources (septum, concha bowl) available.  Therefore rib grafts, which have been used for various purposes for many years, offer an acceptable solution to the problems presented by revision Rhinoplasty.  Like any surgical procedures, there are risks which you have alluded to in your question.  However, autologous costal cartilage grafts offer significantly less infection or extrusion risk in Rhinoplasty than synthetic grafts.

Thank you for the great question. Using autologous (from you) rib in rhinoplasty is not a particularly new practice. It has been a technique in reconstructive surgery for decades. The prominent use of rib cartilage in cosmetic rhinoplasty is a somewhat more recent phenomenon.  The long-term complication that is most feared with costal cartilage grafts is warping -- or shape change/curvature of the graft material over time. Certain techniques are used in surgery to limit this, but it is unfortunately not completely predictable. That being said, the alternatives in cases where a significant amount of grafts are needed are less appealing. With implants in the nose, there is a risk of infection and extrusion over time, in addition to the risks of settling or shifting. This is not an easy decision, but, in my opinion, using your own tissue is always better.
 

Costal cartilage can warp over time, but it depends what the cartilage is going to be used for and how it is going to be used in the nose.  For example, diced costal cartilage has a very low likelihood of warping.  Please consult with a board certified specialist who can assist you in achieving the results you seek.