Is Cadaver Cartilage for Revision Better Than Ear Cartilage?

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.

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 .

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.

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.
 

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.

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.

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!