Ear Cartilage or Rib Graft for Rhinoplasty?

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!

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. 

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.

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.

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

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.

 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.