Dorsal augmentation. Can rib be harvested while leaving the perichondrium in tact?

but... what for? that is a non very logical finesse... any reason's why? perichondrium plays no role and is irrelevant, why should it be re-built?when I harvest rib cartilage I do cut the perichondrium to access the shaft of the rib cartilage, then I lift off the outer layers and harvest the central core of the rib, which is the one warp-exempt.Then I close layers, first muscles and then superficial fascia, finally the skin.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Yes, this is possible.  Another option for dorsal augmentation is diced cartilage wrapped in fascia.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hello,Thanks for your question. Yes, the rib perichondrium is kept intact during rib graft harvest normally. It helps stabilize the rib cage.Dr. Shah

Yes, the perichondrium can be left in place when harvesting rib cartilage. It is technically very easy to leave it intact. However, I frequently find the perichondrium to be helpful during the rhinoplasty and, in general, think that taking the perichondrium is more beneficial than leaving it behind.

Revisionseeker23,
Thanks for your question.  In short, yes, rib cartilage can be harvested while leaving the perichondrium intact.  It is sometimes done this way because the perichondrium, if left intact, can form new cartilage where the old cartilage was removed.  It is also sometimes removed with the cartilage while leaving the cartilage attached so that it can support the cartilage when it is carved into the shape needed for your nose.  Both ways are acceptable, and I think that rather than focus on this issue, focusing on finding a surgeon skilled in revision rhinoplasty is a larger concern, as this is a surgical detail that great surgeons can debate for hours.  Good luck!

I am not sure of the reason for this question. However, the short answer is yes, the perichondrium is essentially always preserved in cartilage graft harvest. The rib cartilage is exposed, the perichondrium is incised and pealed back like pealing an orange. Then the perichondrium is closed.All the best,Talmage Raine MD