The bridge of my nose was low so Dr. George Peck placed a piece of cartilage from my ear on the dorsum. This happened 20 years ago. Dr. Peck did a fine job but the tip of my nose is very rounded and my dorsum is still a bit low. I would like to know if it would be possible to replace the ear cartilage on the dorsum with a thicker rib cartilage to raise the bride of my nose and make the nose tip more pointed. One lateral bone has collapsed and it is obstructing air flow so I need a revision.
Can an Existing Piece of Ear Cartilage on the Dorsum Be Replaced with a Thicker Rib Cartilage to Raise the Dorsum a Bit More?
Doctor Answers 6
Although it depends on how much you are looking to raise your dorsum and what your nose currently looks like, it is likely that the dorsum of the nose can be further augmented using rib cartilage. A thorough evaluation of the inside and outside of your nose is recommended particularly since you are having difficulty breathing. Please consult with a board certified specialist who can assist you in achieving the results you seek.
Rib cartilage for the nasal dorsum
Rib cartilage is an excellent choice to provide adequate nasal dorsal support. It can replace the ear cartilage that was placed twenty years ago.
Ear cartilage can be used for revision rhinoplasty but rib cartilage yields more and stronger cartilage
It's important to be seen in person by a rhinoplasty specialist to determine what is the best way to raise up the dorsum of your nose. Ear cartilage is short and can curl. Septal cartilage is very good but rarely available in long enough pieces after prior surgery. That leaves foreign grafts or rib cartilage. I find that imaging with a discussion of what it takes to raise the nasal profile up "how much" really helps determine if rib is necessary.
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revision rhinoplasty bridge augmentation
Bridge augmentation can certainly be accomplished by removing the ear cartilage graft and inserting it with another piece of cartilage preferably from the nose, or a rib if the nose as been depleted of cartilage. Please see the link below for examples of noses we have performed dorsal augmentation in our practice.
Revision rhinoplasty with rib cartilage
good morning Tristan
the answer is yes of course you can use rib cartilage to revise this. You have a few options but if the dorsum is as low as you describe it rib cartilage may be your best option. You also have the option of cadaver donor cartilage which inexperienced teams can work quite well and save you the added risk (though it is small) and downtime. Of course there's also implants but if you're surgery was 20 years ago and you're getting into your 40s 50s and so on an implant may not be the best thing for you particularly if you have thin skin. If you have some nasal breathing issues from lateral collapse or a narrowed valve internally and your nose you may need what is called a spreader graft.
I hope that was helpful and best of luck
Chase Lay, MD
You had a Rhinoplasty by one of the pioneers of plastic surgery and rhinoplasty.
The short answer is yes you can have a rib cartillage graft to the dorsum of the nose. After examination and assessment of the septum, ears and how much dorsal height you need, one can discuss your options in details and what to expect