Septum and ear cartilage graft: Enough to build up my nose bridge and low radix? Or would I need a graft from rib? (photo)

I am considering rhinoplasty in the next 6/8 months. I dislike about my nose the most is that it quite small and snub like and I would like larger and more masculine with a higher bridge. I particularly don't like my radix as it low and leads to a shadow like appearance around the eyes. I would be open to using a graft from the rib but would much prefer ear and septal cartilidge to be used. I would also like to be able to get a chin implant at the same time would that be possible. Thank you

Doctor Answers 11

Rhinoplasty questions

building up the nasal bridge can be done in a number of ways, with bone or cartilage.  The difficulty is in getting it to look natural.  Make sure you consult with someone who has done cases like yours before and can show you photos of the results.  It is by no means a simple task especially in your situation.


San Diego Plastic Surgeon
5.0 out of 5 stars 25 reviews

Rhinoplasty for a low radix?

You have very good question.  Obviously both ear and rib are reasonable options for your intended surgery, but everything is a matter of degree.    The two main issues we are looking at from the side view are the low bridge especially in the radix area and the tip tilted up some making your nose a little on the short side.  With video imaging, it would be very helpful to see what your intended look is.  Assuming you have not had surgery in the past, your septal cartilage should all be available.  Using your cartilage and your septal cartilage, the tip can be brought down lengthening your nose a small amount and also raising the bridge to some degree.  If you want the tip brought down more than just a millimeter or two, then rib cartilage will probably be necessary.  Rib cartilage can raise the bridge height to a greater degree.  Consider using diced wrapped cartilage to raise the bridge either with your cartilage or rib.  I hope you find this information helpful.  

Thomas Hubbard, MD, FACS
Virginia Beach Plastic Surgeon
4.9 out of 5 stars 32 reviews

Rhinoplasty for a low radix

Although your radix is low the remainder of the nasal bridge has decent height. A septal cartilage graft and possible additional ear cartilage would be all that is needed for building up the radix. A chin implant can be combined and performed at the same time and would give you the best profile 

Kristina Tansavatdi, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

Building up Nadal dorsum

Most likely septal cartilage alone will be enough to appropriately increase the height of your radix, assuming you had no prior nasal/ septal surgery.  

Another important detail to consider when deciding on the source of the cartilage is how this cartilage will be used.  I personally don't like to stack septal or auricular cartilage as it may cause dorsal asymmetry or irregularity.  If I were to use septal or auricular cartilage in your case, I would have probably created a minced cartilage graft (so called Turkish delight graft) which is more pliable and has less chance of asymmetry.  If I wanted to use one piece of cartilage, then rib cartilage graft would be a preferred option in my hands.  

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon
4.8 out of 5 stars 25 reviews

Rhinoplasty with septal and possibly ear cartilage.

Rhinoplasty with septal and possibly ear cartilage. For 35 years I have not needed a rib graft for a nose like yours and can probably get all I need from your nose. A chin implant can be done at the same time. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Rhinoplasty

If you haven't had prior nasal surgery, then you will have enough nasal cartilage to raise your dorsum.  If it isn't quite enough (which I doubt), then extra ear cartilage will suffice.  A chin implant at the same time as your rhinoplasty is a good idea.  Best wishes. 

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Dorsal augmentation

Thanks for your question. I agree that your nose would look better if you had a higher bridge. It is also overly rotated. If you never had surgery on your septum, there should be plenty of cartilage there for an onlay graft and for grafts to push your nasal tip down. Ear cartilage can be used for an onlay graft but septal cartilage tends to work better. 

Good luck!

Robert S. Schmidt, MD
College Station Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Cartilage to Augment Bridge and Radix

You will not need to harvest cartilage from your ribs to augment your bridge and radix with a diced cartilage/rib graft.  Rarely over the last 35+ years have I found it necessary to use the ribs. You should also consider a septal extension graft because your nose looks short in this picture. This can also be taken from the septum or ears. Yes, a chin implant can be done at the same time as your rhinoplasty surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Cartilage for grafting

Hi there,

Thank you for your photo and question.

I do expect you would have enough cartilage in the septum and ear to augment the dorsum and radix (provided you have not had surgery in the septum before). 

Placing a chin implant at the same time of the rhinoplasty is common and should not be a problem. 

I would recommend you consult with rhinoplasty surgeons to have an exam in person and get better recommendations.

Hope this helps! 

Myriam Loyo, MD
Portland Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Rhinoplasty and chin implant candidate

As long as the septum is not been operated upon, there should be enough cartilage  in the nose to be used for grafting purposes to build up the bridge line. Ear cartilage is only used after there is a cartilage depleted nose. A full set of facial photographs are required before making any determination. Chin implants are placed through a small incision underneath the chin under general anesthesia with the rhinoplasty, or under local anesthesia as a standalone procedure. Chin implants are composed of silastic, and are manufactured in a large variety of sizes and shapes which is best determined time of the consultation and examination. For more information and many examples of both procedures, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 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.