Difference between ear and rib cartilage for rhinoplasty?

Question

Hi, are there different reason rib cartlidge would be used over ear? Or is it down to the surgeons preference? Thanks

Donald B. Yoo, MD, FACS · Answer

The amount of cartilage that is necessary depends on the degree of tip projection and dorsal augmentation you want to achieve (how tall you want to make your nose). If you only want a conservative amount, it may be attainable with cartilage harvested from your septum or ear. For a more dramatic change, additional cartilage is necessary which can be obtained from your rib. Good luck! @drdonyoo

John Michael Thomassen, MD · Answer

Rib is more abundant but more challenging to harvest and painful for the patient.  Ear cartilage is less abundant and can lead to ear deformities.  Septal cartilage is the best.  Fresh frozen cadaveric rib cartilage is seeing significant use.

Oakley Smith, MD, FRCSC · Answer

Different sources of cartilage are used as grafts in rhinoplasty depending on many factors including what it will be used for and its availability, among other things. For instance, rib cartilage would be preferred over ear cartilage if you need a large amount of graft material. The curved shape of the ear cartilage may also not be preferable depending on where the graft will be used.

Ronald J. Edelson, MD · Answer

It depends on the type of cartilage needed and the amount needed. Getting ear cartilage is easy but the cartilage is thin and flexible. Suitable for small grafts. Rib cartilage is more stiff and the surgeon can take larger grafts but there would be a scar where the graft is taken from

Elcin Ariturk, MD · Answer

Hi, in rhinoplasty prosedure we use your septal cartilage normally, but sometimes there is not enough cartilage in the middle wall of your nose, so we take the cartilage from your ear or rib.. If your problem is with your alar cartilages we prefer the ear cartilage because of it's curve, but if your problem is with your middle wall or tip of your nose or volume of the dorsum we prefer the rib cartilage because we need a straight cartilage at that time.

Karthik Ram, MRCS, DNB · Answer

Hi.Both ear and rib cartilage can be used in rhinoplasty. It depends on the amount of  cartilage required during rhinoplasty and surgeons preference as well.For large amount of cartilage rib is preferred. But most of the surgeons avoid using rib cartilage for nose surgery. Hope I have cleared your doubt. Thanks for posting your query.

Joseph Shvidler, MD · Answer

Rib cartilage graft is used when a large amount of building material is needed to reconstruct a nose. It is primarily used as an adjunct for building up a bridge of a nose as a dorsal onlay graft or can be used for septal reconstruction as well as spreader and/or batan grafts. Main advantages are that there is plenty of material to work with once it is harvested. The rib can be divided into many thinly sliced grafts. Disadvantages are that it increases length and cost of procedure, and has additional risks. the grafts can warp and are very firm. Best use cases are for secondary or tertiary revisions, someone who wants a more sculpted, projected nose and for someone who wants to build up a bridge height. Also, it is very useful in reconstructing a saddle nose deformity. 
  Ear cartilage is my most commonly used go to graft when performing revision surgery, it is soft and pliable and matches the flexibility of the native cartilages. Although easier to harvest, sometimes there is not enough cartilage to perform all the grafting.  The cartilage is too soft for some structural grafts. The best use cases are for sculpting the tip and bridge of the nose.

Difference between ear and rib cartilage for rhinoplasty?

Answers (7)

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