Should I use ear or rib cartilage for revision rhinoplasty (tip)?

Question

I had an overly-aggressive nose job and now I’m planning to undergo a revision. I do not have enough septal cartilage and must therefore use rib/ear. I have heard that ear cartilage is more likely to deform due to healing forces/scar tissue than rib cartilage. Is this true or does it depend on where the grafts are placed? I have a pinched tip and valve collapse, so I will need grafts in the lower part of my nose.

Thomas A. Mustoe, MD, FACS · Answer

Ear cartilage is easy to obtain but is very floppy and not good for structural support.  It adds volume and so can be used to filling some defects.  In your situation with too much cartilage removed the scar tissue that forms as part of the healing adds stiffness to the tissues so stronger less flexible cartilage is needed.  Rib cartilage takes a little longer to harvest but for you would be preferable.

Suleyman Tas, MD, FEBOPRAS · Answer

Hello, Thank you for the question and provided question.  Ear cartilage has high elasticity and sufficient thickness, and retains a natural curve. Thus, it is appropriate for areas requiring curvature. Rib cartilage last longer to be harvested and provides better structural support, for your case rib cartilage is more preferable.Kind Regards,

Bianca Knoll, MD · Answer

thank you for posting your question. Rib cartilage gives your surgeon more material to work with, especially when several grafts are being needed to reconstruct a nose. Rib cartilage is also sturdier and gives a surgeon the opportunity to creat several straight grafts. Ear cartilage is curved. An experienced rhinoplasty surgeon will be able to hide the scar of the rib harvest in the breast crease. Best of luck.Bianca Knoll

Richard W. Fleming, MD (retired) · Answer

Over many years I've rarely found it necessary to use rib grafts in revision rhinoplasty. It is much easier for the surgeon and less invasive for the patient to harvest ear cartilage. In experienced hands this provides consistent excellent results.

Should I use ear or rib cartilage for revision rhinoplasty (tip)?

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