I only have ear cartiledge left and don't want to use rib. I had my right nostril alar notching improved with a septal graft but it might not have been strong enough because it still falls in a bit and from front view appears as a divet, from underneath appears as assymetrical. My surgeon suggests going back in with ear cartiledge but I wanted to know if it holds up long term? I have heard it has a tendency to curl and I do not want more surgery...
Is Ear Cartilage a Proven Material for Alar Rim Grafting?
Doctor Answers 3
Your posted photos show a deviated septum, asymmetric tip cartilages and a notch in the right ala. That is a complex problem that I do not think can be fixed without an open rhinoplasty and just sticking in cartilage grafts will not work. Not knowing how many nasal procedures you have had, what exactly was done at the time of surgery or what you looked like before the surgery it is impossible to know exactly what needs to be done to correct the situation. I assume septoplasty, suture realignment of the tip cartilages and camouflage cartilage grafting to the tip would be required. Complete or exact symmetry is not likely achievable though.
Having already had nasal surgery you are right to move forward very cautiously.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Ear cartilage for alar rim grafting
Ear cartilage for the alar rim in rhinoplasty - nose job
Ear cartilage can be useful for the alar rim as it is soft and curved. This provides a less noticeable appearance and follows the curve of the alar rim. This may be a good plan for improving the collapse of the alar rim. Good luck.