Do you think cartilage from 2 ears is suitable for a 3mm bridge augmentation? How much (in mm) of the bridge can cartilage from 1 year augment (Approx.)? Do you recommend the cartilage be diced and wrapped in fascia and can is re-absorb? Also, is it possible to make nostrils "Bigger" from the profile view if they were reduced too much to my liking? How would this be done (they were once VERY big before surgery)...
Ear Cartilage Good for Augmentation?
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Doctor Answers 8
Ear cartilage for revision rhino augmentation
Revision rhinoplasty is a very difficult operation to perform in the field of cosmetic surgery. Ear cartilage grafting to the nasal bridge can be used, however, it is not the most smooth and symmetrical type of cartilage and does not blend very well to augment the entire bridge line. It is very irregular and is difficult to use in a very long nose. It can give anywhere from 2-3 mm of bridge augmentation. It is impossible to make the nostrils any bigger in a profile view since this skin was removed to make them smaller. Nasal septal cartilage is the best material to augment the nasal bridge because it is smooth, straight and works much better than ear cartilage.
Diced Cartilage Works Great For Augmentation Rhinoplasty
DIced cartilage works great for nasal augmentation. Whether the source is ear or rib, cartilage can be diced and wrapped in deep temporal fascia. Whether or not you have adequate cartilage stock in your ears for your nose will depend on the size of your ears and deficiency on your nasal bridge.
Is ear cartilage good for bridge augmentation?
I have preformed Rhinoplasty for over 20 years and sadly, IMHO, the answer is no...ear cartilage (conchal cartilage) is curved and as such does not make a reliable straight cartilage graft to build up the nasal bridge. My experience is that ear cartilage tends to dissolve and do so unevenly, years after the Rhinoplasty making a revision Rhinoplasty to remove it and replace it with a more stable doral (bridge) graft, like a straight silastic one, a necessity. IMHO, the following work best wiith a Rhinoplasty.
- Conchal cartilage works best in the nasl tip area.
- Septal cartilage (rarely l;ong enough, IMO) and straight silastic implants work best for building up the nasal bridge.
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Ear cartilage nasal augmentation
Ear cartilage is an excellent source of tissue for nasal augmentation. I generally wrap the diced cartilage in a temporalis fascia covering to decrease resorption. This can be used for augmentations for most cases. In severe cases rib cartilage may be needed. Donald R. Nunn MD Atlanta Plastic Surgeon.
Ear cartilage can solve SOME dorsal problems; nostrils can be enlarged
Ear cartilage is soft, rubbery and elastic--and not everyone has ears the same size--i.e., to supply a graft that is long enough. Optimally, a dorsal graft should extend in one piece from radix "top" to tip. This is the best way to get a great long term result. I use rib or septal cartilage usually. If your ears are large enough. the cartilage can be rolled to make a thicker graft. It is much better if the dorsal defect is short, slightly asymmetrical, and if your soft tissues are thick enough to hide the edges. I have seen too many bad results from other surgeons' diced cartilage to recommend it. The original descriptions are not convincing to me.
The nostrils an be enlarged by small flaps from adjacent to them or by "composite" skin and cartilage grafts form one of your ears. I do these procedures commonly and have reported both techniques in Plastic and Reconstructive Surgery.
There are many ways to augment the nasal dorsum. Iprefer septal cartilage over ear, if there is enough. you might consider alloplastic implants that don't disappear. Gortex or silicone are two examples.
Cartilage wrapped in Fascia: a great way to augment the dorsum
One of my favorite ways to augment the dorsum is to use ear cartilage wrapped in Fascia, the so-called "Turkish Delight." It does resorb some, but overall I have been impressed with the long-term results. Making the nostrils larger is more difficult--I have had some success with using fillers like Restylane to augment the soft tissue of the nostrils, but it is very hard to make the nostril openings larger, if that is what you desire.
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