Which is Better for Building Nose Bridge for Afro-Am: Your Own Rib, Frozen Rib, or Ear?

I'm African American female & considering primary rhinoplasty to slim the bridge & remove a hump from my nose. I've been to several consultations with a few doctors, & each has suggested different types of cartilage they prefer using to raise my nose bridge. One suggested using ear cartilage, another suggested my own rib, and the last suggested frozen rib/cadaver cartilage. But I'm getting mixed reviews on each. So I want to know which cartilage is best for a natural look/feel & longer results?

Doctor Answers 7

Augmenting Nasal Bridge for African-American Female

Over the last 30 years I have always prefered using the patient's own cartilage. Rib cartilage can be used but this requires another incision on the woman's chest. I usually place diced cartilage from the septum and ear which is wrapped in fascia.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

You need to clarify a few things


You said that you want a hump removed but then you said you want your bridge built up.  Typically dorsal hump removal means the bridge is too high as in a middle eastern or a Jewish nose and removing the hump drops the bridge height down.  In most (most but not all) Black patients and Asian patients, the bridge is too low and flat and it requires building it up by adding cartilage.  Ear cartilage is not good for the bridge even if many plastic surgeons continue to use it for the bridge.  Frozen rib or your own rib are essentially about the same as studies from Texas with a large number of patients have shown.  Choose the right doctor and go from there.

Shervin Naderi, MD, FACS
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 108 reviews

Which is Better for Building Nose Bridge for Afro-Am: Your Own Rib, Frozen Rib, or Ear?

I always recommend using your own ear cartilage. It heals predictably and has a lower risk of reabsorption or warping compared to donor cartilage. If cartilage from the ear is enough, that would be my first choice as there is no visible scar and minimal risk of complications. If more cartilage is needed it can be taken from the rib and the incision placed in the breast crease where it heals well. This is more involved than taking ear cartilage but can be done safely.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Best Material to Build Up the Nasal Bridge

Manufactured silicone dorsal nasal implants would typically be my first choice to build up a bridge. If sufficient septal cartilage exists to do the job, then I would use that. Properly placed and sized implants have a low complication rate. Ear cartilage can warp and make it difficult to get a nice straight dorsal profile. Rib cartilage can warp or bend over time as well. Each of these materials requires a separate incision and possiblity of donor site morbidity. For the tip of the nose - septal, ear or rib cartilge works well and would be the primary materials I would use. Best of Luck  Dr Harrell

Jon F. Harrell, DO, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 49 reviews

African American Rhinoplasty

The questions is unusual due to the fa t you are discussion removing a hump from the bridge which will further reduce the bridge. Photographs would be extremely helpful in providing an expert opinion. With this said I prefer to use a silastic dorsal implant on my African American and Asian patients for enhancing the dorsum. Best regards!

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

Which is bettere to build up the nasal bridge, rib cartilage, ear cartilage or banked cartilage?

I MHO after over 20 years of performing Rhinoplasty, I'd say none of the above.  Rib cartilage/bone from you or irradiated from donors or ear cartilage folded on itself because it's curved not straight all have been shown to dissolve unevenly over time.  I do not use any of these for that reason and only use straight silastic dorsal implants.  These are reliable and will not dissolve.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

African American Rhinoplasty

The best implant is the one the surgeon is comfortable using and can show you consistent results. I have performed African American Rhinoplasty for the past 10 years  and always use "custom carved silicone implants". I believe that these implants provide consistent results. Below is a website that I have dedicated for African American rhinoplasty that describes my technique and shows many before and afters. Remember, the type of implant doesn't matter as long as the surgeon can show you good results.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 273 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.