Is rib cartilage grafting for rhinoplasty revision to lift the nose a must for people with ethnic thick skin? (Photos)

Question

my plastic surgeon who is an ENT recommended grafting rib cartilage for my rhinoplasty revision to lift and define the nose tip . he said because i have a thick skin and because it is a revision it is impossible to get my wish result without grafting .

Andrew Miller, MD · Answer

Based on your photos, you are a great candidate for rhinoplasty. During the procedure, some cartilage from your septum is often used, but sometimes it's not strong enough. The rib cartilage may hold much better support and the skin of your tip looks heavy. Just make sure the surgeon has a lot of experience with rib cartilage.

Man Koon Suh, MD · Answer

Thank you for your question. As your ENT doctor said, the skin oof your nose is thick and tip drooping is severe, so a cartilage graft is essential. Through structural cartilage graft, nasal tip can be projected and more defined and also retruded columella can be corrected. Required cartilage can be septal cartilage or rib cartilage.

Marc Polacco, MD · Answer

Thank you for your question. The answer depends on what was done during the first surgery. If there is significant weakness of the septum and associated cartilages, then using a rib graft is a great way to increase the strength and structure of the nose. Rib cartilage also helps hold against the contractile forces thick skin will place on the underlying structures. So in general it's probably a good idea to at least have the possibility in mind. All the best.
-Dr. P

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Great question. In ethnic rhinoplasty, the skin tends to be quite thick and needs to be stretched to create definition. Rib cartilage is very strong and assists with providing the strength needed. Ear cartilage doesn't hold form very well. Septal cartilage can work, but there often isn't enough available to augment to a certain level. Downsizing a nose is possible, but creating the same level of definition as a thinned skin nose may be unrealistic. Thinning the subcutaneous tissue is often done during surgery, but you have to be careful not to disrupt the blood supply. Steroids post procedure are very helpful in addition to taping, especially at the tip. Hope this helps!

Is rib cartilage grafting for rhinoplasty revision to lift the nose a must for people with ethnic thick skin? (Photos)

Answers (4)

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