A doctor gave me a choice to choose between a enginnered rib or my own rib cartilage to augment my nose. My nose is short and my skin is thick therfore cartiage from my own nose is not enough for the height and length I'm trying to acheive. I would like to know what is an enginnered rib, I'm thinking it's sombody elses rib. Secondly is it safe and does it last forever.
What is an Engineered Rib? Is It Safe? How Long Will It Last?
Doctor Answers 5
Your best bet is always to use your own rib cartilage for a number of reasons:
- Your own rib will resist infection better than engineered rib or implants
- Your own rib will be less likely to resorb (go away) over time
- Your own rib will not contain any diseases that may not be known today (thus not tested for)
- Do you really want a dead person's body part in your nose?
What is engineered rib?
Your surgeon likely is referring to cadaver rib cartilage that is treated to remove any cells that would be seen as "foreign" to your body. The cartilage is radiated and sterilized during the processing. The tissue is normally obtained from a tissue bank that does extensive testing to prevent the transmission of any infectious diseases.
Cadaver rib has been shown to have very good long term results in various studies. Some people have found that in their hands this processed cartilage does resorb more than someone's own rib cartilage.
I tend to prefer using a patient's own rib cartilage whenever possible (and according to patient preference). If a patient is older their rib cartilage may be too calcified to use, however.
The term "engineered" rib probably refers to rib harvested from a donor that has been irradiated to avoid rejection by your immune system and then sterilized. I always feel it is better to use the patient's own tissue whenever possible. Although it is easier for the patient when rib does not have to be harvested from their chest, the cadaver cartilage does tend to absorb more than your own tissue.
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Cadaveric vs Autogenous Rib For Rhinoplasty
The term 'engineered' rib is probably not the best term to use to describe a xenogeneic rib or cadaver rib. It is manufactured/processed from cadaver bone although not always necessarily a rib. That is different than a truly engineered rib which is one that is made in a laboratory out of cultured chondrocytes, an appealing method that is not yet commercially available. Cadaveric rib tissue has an unpredictable volume retention and is prone to some resorption over time. This is not true of using your own rib where the risks of infection and resorption are much less...but at the price of a donor harvest.
Donor rib vs. your own
Donor rib is irradiated & sterilized rib used for nasal surgery, typically the bridge. This compared to your own is this:
1. The engineered or donor rib tends to resorb a bit more than your own (which also resorbs but more predictably) so it needs to be oversized a bit when placed.
2. Engineered rib has fewer risks to you in that you don't have to worry about donor site complications.
They're are much more remote risks with engineered rib such as in containing viral elements, etc. but these are tested for and the tissue is sterilized.
Hope that helps
Chase Lay, MD