Revision rhinoplasty with Rib? Risks? Warping?

I am wanting a revision to build up my bridge similar to b4 septorhinoplasty. I don't have septum cartilage so rib would probably be the option for dorsum augmentation. I've seen it can warp & reabsorb as some of the risks. Since I will need a significant amount.. does this mean it could potentially completely reabsorb? Or warp/absorb to some degree but not completely? I know there is no certain answer as everyone is different but on average what seems to be the case for rib augmentation?

Doctor Answers 4

Rib Cartilage may or may not warp

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Aesthetic preference is a personal decision. Based on your picture, it appears you've had a good result from a technical point of view but if you desire more bridge projection then a diced cartilage technique with fascia or fascia alone should be able to provide you additional augmentation with minimal risk of warping. There can be some issues with asymmetry, resorption, etc as with all cartilage grafting, but warping wouldn't be an issue. Since it does not appear you need a great deal of augmentation, ear cartilage would also be an option with fascia. 

Seattle Facial Plastic Surgeon

Functional and aesthetic revision rhinoplasty

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Indeed, rib cartilage is used for more significant dorsal augmentation of the nose-  additional areas other the septum include ear cartilage for smaller areas but a plastic surgeon would need to assess all the views of the nose along with a physical exam

Revision rhinoplasty

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thanks for this question. First, I agree with the statement below it does not appear you need augmentation of your dorsum but an in person consultation would be a lot of help for you.  I would like to see your front view based on glimpses from the profile.  Lastly, rib may resorb and warp but fixating it or dicing it up works quite well.  Also,  ear cartilage is an option for you as well if truly no septal cartilage is left. Hope this helps. 

Taha Shipchandler, MD
Indianapolis Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Prevention of rib cartilage warping

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 There are 2 very reliable ways of preventing the rib cartilage warpage. One is a suture technique  that I have described that resists the warping. The second is dicing the cartilage before the it is delivered to the site. However, from the posted pictures it does not seem that you need augmentation of your bridge.

Happy Thanksgiving

Bahman Guyuron, MD
Cleveland Plastic Surgeon
4.7 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.