Rhinoplasty with rib cartilage - does cartilage wrap over time and can volume be increased to minimize graft size?

Question

Hello, I was reading about the use of rib cartilage for augumentation and had a few questions. Does it wrap overtime? Is the wrapping based on which section of the rib is used? Also, is there a way to increase volume in the supratip area so the flow between the bridge and tip is more smooth without adding a graft to the entire bridge? I hope that makes sense, thanks

Selcuk Inanli, MD · Answer

Hello! Thank you for your question. Unfortunately, it is not possible to make a proper evaluation without any photos. If you can provide photos from front of your face, from the side of your face and 1 meter away I would be able to make a proper evaluation. It would be more convenient to decide with face-to-face consultation. Best Regards!

Donald B. Yoo, MD, FACS · Answer

A rhinoplasty specialist will be able to comprehensively address the issues you have with your nose. DCF (Diced cartilage fascia) provides permanent results without the risk of warping or resorption compared to en bloc rib cartilage, and with a much lower rate of migration, infection, or extrusion than synthetic grafts. Cartilage grafts are carefully crafted to construct a beautiful nose that caters to each individual. While there are a variety of approaches and techniques employed by various surgeons, it is up to you to do your due diligence to find a rhinoplasty specialist in order to achieve the best results possible. Good luck! @drdonyoo

Zoran Potparic, MD · Answer

It is very hard to discuss such a broad question. Without photos or, better, in person exam, it is difficult to say whether you need dorsum augmentation, how much of it and what method would provide best result. It would be in your best interest to discuss this issue with a board certified plastic surgeon, expert in rhnioplasty, after a detailed evaluation. Good luck.

Celal Alioglu, MD · Answer

Hello yes if you don't have a enough cartilage inside of your nose we can use it from your rib and you will not any problems don't worry

William Portuese, MD · Answer

In our practice, we do not recommend rib graft rhinoplasty for a variety of reasons which you have mentioned in your question. Much more information is needed such as a full set of facial photographs from all angles to make a determination about how best to proceed with your nose.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
Rib cartilage is harvested from a relatively small incision at the 5th or 6th ribs. This location is chosen for rib thickness and adequate donor tissue available size . The central core of the cartilage is utilized as there is less warping tendency. 
Nasal bridge augmentation can be accomplished with bone, cartilage, or synthetic material (a plastic). Synthetic materials have a higher extrusion rate. Temporary nasal bridge augmentation of relatively small areas can be accomplished with the use of injectable soft tissue fillers composed of hyaluronic acid, providing 4-6 months of elevation before resorption.
The length of the graft depends upon the length of the defect. If the entire bridge is involved, the graft must extend from radix to tip. If it involves a localized segment (saddle nose deformity), only the depression requires augmentation.
Visit a board certified plastic surgeon for evaluation and discussion.
Best wishes...

Rhinoplasty with rib cartilage - does cartilage wrap over time and can volume be increased to minimize graft size?

Answers (6)

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