What Are the Implications of Having Weak Nasal Cartilage in Rhinoplasty?

Cartilage and bone are the two types of tissue that provide support to the nose. If a patient has "weak" cartilage, then several different techniques must be used in order to both provide the appropriate amount of nasal support and to produce the cosmetic result desired. Suture techniques and cartilage grafts are the two most commonly used methods for creating nasal support or "strength" in rhinoplasty surgery. A columellar strut is a good example of a cartilage graft that is usually taken from the nasal septum and placed between and below the tip cartilage in order to increase nasal tip height, projection and support. When done properly and in combination with suture techniques, this should create an appropriately sized and aesthetically pleasing nose.

Hi from Istanbul, thanks for your question. Having strong nasal cartilages is crucial in rhinoplasty as they provide essential support, particularly in the tip area, creating more defined nose contours. Common issues, especially in ethnic rhinoplasty patients and those with thicker skin, include depressed, flat noses with poor definition and bulbous tips. These problems often stem from weak or inadequate cartilage. To enhance and refine these areas, to help support the new shape of the nose, cartilage grafts are typically used. Hope this helps.

If you have weak nasal cartilage in the tip, then removing too much of it could lead to collapse of the nostrils and problems breathing. You mention that usually it requires cartilage grafts. I disagree with that. I use cartilage grafts only occasionally and almost never with a primary ( first time ) rhinoplasty.

Weak nasal cartilage usually means that the cartilages are very thin and atrophic and are easily collapsible. Certain types of grafts, such as a spreader graft, are used to bolster and strengthen and slightly widen the area of the nose where they are placed.  They only appear slightly larger.  At the time of your consultation for your rhinoplasty surgery, examination of the presenting anatomy will determine whether grafts are needed.

Weak cartilage is actually a phrase I use often when describing cartilage quality to my patients. Cartilage can be weak in that it is thin, damaged (by previous rhinoplasty), or is in an improper angle/orientation.  All this can be altered and should be worked on during your procedure to prevent future problems and need for revision surgery. Adding cartilage or re-arranging the cartilage you already have is key. I often have to completely re-sculpt, relocate, augment,  or re-orient existing cartilage to create strength and shape that is aesthetically pleasing, simultaneously. You CANNOT have aesthetic nasal shaping without also maintaining or improving strength.