Solid rib graft vs diced cartilage wrapped in fascia? (Photo)

One of the most challenging defects to improve after a primary rhinoplasty is a bridge (dorsum) that has been over reduced. Patients who expect to return to the original bridge height will often be disappointed. Typically, the bridge is only a few millimeters too low. Adding a big, solid rib cartilage graft may create too much height with a risk of warping or visibles edges. Diced cartilage may have issues with bumpiness, contour, or bunching in the supratip. Synthetic implants have a life-time risk of infection. Finding the right surgeon, who has experience in revision rhinoplasty and they are comfortable with addressing the issues that go along with the dorsal augmentation technique they use, is of the utmost importance. I encourage you to get a few opinions. Ask them specifically about the risks of the technique they use and how they can get you a safe outcome. 

Diced cartilage is almost always better than a solid rib graft. It has less risk of asymmetry, shidting and any visible edges. It will feel solid within a few weeks after surgery.

I personally prefer to use diced cartilage wrapped in fascia. I have found the feel of the wrapped cartilage to be superior to a rib graft.With time the rib grafts tend to look like a toothbrush handle.