Is rib cartilage placed on the bridge more likely to warp?

Question

Is rib cartilage placed on the bridge more likely to warp than say a rib cartilage placed near the tip? Or is the likelihood of warping the same and not dependent on where the graft is placed?

Afshin Parhiscar, MD · Answer

Dear UppyRib cartilage can warp and most surgeons try preventive techniques to minimize that risk. In my experience, symmetrically carving the cartilage for the nasal dorsum placement minimizes that risk. I also think that the longer  the piece used, the higher the chance of warping. There are surgeons that use K-wires inside the rib cartilage to stabilize it and prevent warping.  Smaller pieces used as strut grafts tend to be stable. Alternatives to rib graft such as silastic implants also work well in the right patient.You should seek consultation with an experienced and Board certified surgeon to get information specific to your case.

Shim Ching, MD · Answer

Thank you for your question.Rib cartilage can warp.  This is a known complication of utilizing this material for rhinoplasty.  Generally, rib cartilage is not used at the tip of the nose, but can be used to support the tip.  Softer cartilage, such as septal cartilage or ear cartilage is better for reshaping the tip of the nose.  Larger segments of rib cartilage likely have greater risk of warping.  The location where the cartilage is placed may be a factor, but in my opinion it is less of an influence than other factors such as size, quality of cartilage etc.

Barry L. Eppley, MD, DMD · Answer

The shape of a rib graft changes based on where it is used and its shape. When placed on the bridge the graft is long and a single piece and thus is more prone to warping. When used as a columellar strut in the tip, the rib graft is much shorter and the risk of warping is very low.

William Portuese, MD · Answer

The primary choice  for cartilage grafts  is nasal cartilage first. If the nose is been depleted of cartilage from previous surgery, ear cartilage is then considered. Only after those 2 sources have been exhausted does one consider a rib graft and then accept the potential complications of  warping

Michael T. Somenek, MD · Answer

Rib cartilage always has a risk to warping. It is very surgeon dependent on how it is carved and placed. Technique can markedly can decrease the chances of this happening. I would recommend seeking a rhinoplasty surgeon who routinely uses rib cartilage in the nose. Best of luck.

Richard W. Fleming, MD (retired) · Answer

Rib cartilage can warp if used to augment the bridge. That's why I use diced cartilage, regardless of the source, wrapped in fascia to augment the bridge to avoid this complication.

Is rib cartilage placed on the bridge more likely to warp?

Answers (6)

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