Pros and Cons of Grafting in a Nose Job

Grafts are just another technique and are neither safe nor risky in any absolute sense.

The pros of grafting include better/stronger structure and more options in reshaping the nose. The cons include greater skill requirements by the surgeon, potentially longer surgical times, potential donor site problems (e.g., a rib graft creates a small scar on the chest), and the possibility of the graft showing to obviously down the road.

When I can use suture techniques, I do. But I also use a lot of grafts when needed (especially in revisions).

All the best,

--DCP

Most surgeons use septal cartilage first, then ear. then rib. Septal is easy to get and works very well if the surgeon is experienced. Rib cartilage is used when we done have ear or septal cartilage available. The grafts are safe to use and should not be avoided if they are needed!

Not all noses require cartilage grafts. Cartilage grafting is used only when needed such as in the tip, the bridge or spreader grafts in the mid third of the nose. They are very safe to use and it is not a good idea to avoid them when needed. The best cartilage to use is always going to be septal cartilage. The second best cartilage to use would be ear and then rib.   Cartilage grafts  placement can be accomplished with a closed rhinoplasty approach with all of the incisions placed on the inside of the nose. We have performed cartilage grafts in many of our rhinoplasty patients in our practice and have had excellent success with both nose and ear cartilage.

Placing grafts within thenose is very common during rhinoplasty. In many cases the best cartilage is from the septum.

Cartilage grafts have their place. They are used either for structural support (to hold the tip unit up, to widen the breathing space, to elongate the nose of the tip, to support a nose which collapses on deep breathing) OR they are used for cosmetic region to give the back of the nose a narrower look or the tip of the nose a more refined look. When patients have very thick skin cartilage tip grafts are needed to provide more tip definition.

The benefits of cartilage grafts are easy availability, they take easily and are relatively resistant to infection. The potential problems with them is mobility, warping and thinning of the overlying tissues among others.

Total agreement with Dr Mayer. But you really need to see in person boarded surgeons to discuss in detail. Seek the route.

From MIAMI Dr. B

Grafts are not always necessary and preferable not to use them for they can themselves cause problems like uneveness, asymmetries. When I use grafts, I first use the cartilage/bone that I have removed from the actual rhinoplasty. If that is insufficient, I harvest cartilage from the septum. If that has been "used up", I use ear cartilage and finally rib grafts.

When performing rhinoplasty, a surgeon may decide to employ tip grafts for several reasons: to add structure, alter shape, projection or rotation, and for  symmetry or camoflage. Not every case requires grafting. Consultation with a skilled rhinoplasty surgeon will reveal the likelihood of the need for this versus other techniques.

Cartilage grafts are used by all experienced rhinoplasty surgeons in some noses.  Most surgeons will use septal and/or ear cartilage when available. Depending on the quantity of cartilage needed, ribs are usually the last choice. Grafts are frequently helpful and sometimes necessary to to provide nasal strength and/or contour. 

Hi.

In most patients, the tip can be sculptured with internal stitches during rhinoplasty.  But cartilage grafts are safe when needed.  We use septal cartilage grafts.