Ear Cartilage or Rib Graft for Rhinoplasty?

I had a nose infection before so using a silicone implant was strongly not recommended. One of the surgeons I saw said that rib grafts will warp over time so using ear cartilage is more ideal. However rib will give a bigger better result + I dont have alot of ear cartilage cuz some of it (or all of it?) has been used in one of my ears. Soo help me out ?

Doctor Answers 7

Cartilage grafts in rhinoplasty

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Actually, ear cartilage is more likely to warp than rib cartilage because is is thin and softer than rib.  The choice really depends on what the cartilage is being used for.  If is is being used for replacement of tip cartilage, ear cartilage is usually better.  If it is being used to build up the nasal bridge, the rib graft will be better because a thicker and straighter piece of cartilage can be far vested from the ribs.  Good luck!

San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Cartilage grafting

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Non-biologic implants like silicone will get infected 3 - 5% of the time.  However they will maintain their shape.

Cartilage implants are much less likely to get infected, however they will tend to re-absorb over time in about 5% of cases, less if they are fixed in position.

Rib cartilage can warp, but this will occur within 20 minutes of being cut so I wouldn't worry about warping over the long term.

Douglas J. Kibblewhite, MD
Vancouver Facial Plastic Surgeon

Ear or rib cartilage for rhinoplasty

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Nose cartilage is the primary cartilage that should be used for nasal reconstruction.  If the nose has been depleted of harvestable cartilage, then the next alternative would be ear cartilage.  In a severe saddle nose deformity, rib cartilage should be considered.  Ultimately, it really depends upon the amount of augmentation required as to which grafting source would be the best alternative.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Rib or ear cartilage

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Often times the ear does not give enough solid cartilage to provide enough dorsal projection.  It is best to use your own rib or one can use Irradiated homograft costal cartilage.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revision rhinoplasty with prior infection.

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I would not use silicone! For 35 years of revision rhinoplasty I have never had to use rib which is painfull and expensive. Ear cartilage and soft tissue is my material of choice if all the septal cartilage is gone. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Ear Cartilage or Rib Graft for Rhinoplasty?

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 That's unfortunate that you had a previous infection from a Rhinoplasty because the reality is IMO that a man made dorsal nasal implant is the only one that will not dissolve unevenly with time.  Rib cartilage/bone, bone, banked cartilage as well as ear cartilage used as a dorsal implant all have this issue.  Ear cartilage works great for nasal tip implants but not folded on the bridge.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Ear Cartilage or Rib Graft for Rhinoplasty?

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The answer to your question depends primarily on how much cartilage will be required. Ear cartilage is very easy to obtain and it is easy to work with and very predictable. Rib cartilage grafts require a scar on your chest and requires a more extensive surgery to harvest. Thus, if you only need a small amount of cartilage to achieve your rhinoplasty results, an ear cartilage graft is ideal. If you need alot of dorsal augmentation or structure that an ear cartilage graft won't provide then you are probably better served by a rib graft. You can also use cadaveric (donor) rib cartilage which precludes surgery on your chest but this has a higher tendency to reabsorb and warp, not the mention the occasional philosophical concerns of patients receiving cadaveric graft material. I hope this information is helpful.

Stephen Weber MD, FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.