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Is Cadaver Cartilage for Revision Better Than Ear Cartilage?

I need to have a septal hole repaired along with augmentation of an upturned shortened nose from a previous rhinoplasty. Found a wonderful ENT/PS who recommends cadaver cartilage. He can use that or one or both of my ears. I am reading so much on the possibility of warping and reabsorption that I am so confused. What are the experiences of most revisionist these days? Is cadaver cartilage really safe? What happens if it does warp or reabsorb? Thank you very much for the advice.

Doctor Answers 7

Irradiated Cadaver vs Ear Cartilage in Nasal Revision

January 21st, 2011
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Irradiated cadaver cartilage is safe but the problem with absorption will vary depending on your surgeon's source of that cartilage.  After 35 years of doing revision rhinoplasty I have used all these materials and now prefer to use the patient's own cartilage from the septum, ears, or rib. If adequate cartilage can be harvested from your ears, that would be my first choice.

Richard W. Fleming, MD


Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 35 reviews

Irradiated cadaver rib (costal) or ear cartilage for revision nose job (rhinoplasty)

January 16th, 2011
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There appear to be trends and conflicting information on the use of irradatiated rib cartilage. Clearly the advantages are that no donor site or additional srugery is necessary. However, any rib  cartilage yours or a cadaver can warp. Interventions such as metal wires placed into the graft may help minimize this tendency but may require removal at a later date. Ear cartilage will not be rejected but the ability to shape of provide sufficient bulk or structure may be more limited.

Web reference: http://www.bodysculptor.com/

Otto Joseph Placik, MD

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 72 reviews

Irradiated Rib Cartilage

January 16th, 2011
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Good question.  There is still some controversy regarding the use of irradiated cadaveric rib cartilage in nasal reconstruction.  The main concern was not safety, but resorption of the homologous rib graft over time.  Recent studies have shown that about one third of these grafts will lose support and resorb over time.  This would be a problem in cases like yours, were the surgeon is trying to lengthen the nose or reconstruct the septum. In bigger reconstructive cases,  a patient's own rib cartilage would be my first choice. However, if (for whatever reason) rib harvest is not available, then irradiated homologous rib grafts would be my next best option in these cases.

Daniel Reichner, MD

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 35 reviews

Cadaver cartilage is am excellent choice

January 15th, 2011
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The irradiated cartilage is a great solution. Your own ear cartilage is difficult to straighten, and carries with it a real potential for an ear deformity. It is very safe and avoids the need for a donor site. If the cadaver cartilage is properly carved it is less likely to curve. Your surgeon's experience is very important!
Verne Weisberg, MD

Verne Weisberg, MD
Portland Plastic Surgeon
4.7 out of 5 stars 17 reviews

What is the right graft for revision rhinoplasty

January 15th, 2011
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Dear Rhinoplasty Patient from Florida,
Irradiated cadaver cartilage is an excellent choice for most revision rhinoplasty cases. Remember having cartilage harvested from your ears or ribs requires additional surgery and recovery. It seems your facial plastic surgeon has a good handle of the situation. Talk to him for more information. Good luck.
 

Web reference: http://www.galleryofcosmeticsurgery.com/face-procudures/rhinoplasty.html

Kevin Sadati, DO

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
4.9 out of 5 stars 171 reviews

Irradiated cartilage

January 15th, 2011
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Irradiated cartilage like any cartilage to be use can warp after use.  It is a good substitute to avoid having rib harvesting done which can be quite painful post-op.

Web reference: http://www.stevenwallachmd.com

Steven Wallach, MD

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 23 reviews

Autologous vs Irradiated Rib Cartilage in Revision Rhinoplasty

January 22nd, 2011
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There are Pros and Cons for using Irradiated vs Autologous Rib Cartilage in Revision Rhinoplasty Patients-

1. Irradiated Rib Cartilage- No donor site morbidity, ease of use , less warping but more resorption than Autologous Rib Cartilage

2. Autologous Rib Cartilage- Abundant, donor site morbidity, ease of carving, more warping tendency but less resorption .

In my personal experience, I have moved to using only autologous material- septum , ear or rib in the management of revision rhinoplasty patients for enhanced long term results, safety ,and less resorption rates .

Rod J. Rohrich, MD

Rod J. Rohrich, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 45 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.