I'm considering rib asian rhinoplasty, but scared of its possible warp. Is there a way to assure me this can be prevented?

Question

I'm considering rib asian rhinoplasty but really worried about what I'm learning through my research on this. I'm worried about the warp, but is there a way this can be prevented?

Gerald Minniti, MD, FACS · Answer

Modern techniques generally lead to little rib graft warping: using only the core portion of rib, soaking cute pieces for at least 30 mins, and securely suturing the graft. The risk of warping is less than 5%.

Donald B. Yoo, MD, FACS · Answer

A rhinoplasty specialist will be able to comprehensively address the issues you have with your nose. One thing to keep in mind though is that there is a limitation to the amount of tip refinement you can achieve (how small/narrow) depending on the thickness of your skin. DCF (Diced cartilage fascia) provides permanent results without the risk of warping or resorption of en bloc rib cartilage, and with a much lower rate of migration, infection, or extrusion than synthetic grafts. 
Consult with 2-3 of these surgeons in person and determine your comfort level with their approach, demeanor, and before and after results. Good luck

Edwin Kwon, MD, FACS · Answer

Rib segments can become warped over time, although this is generally rare.  If utilizing an en-bloc piece of rib, there are techniques to minimize warping including allowing the rib to soak and warp prior to cutting or cutting certain segment of the rib.  Despite these techniques, the rib still can wrap over time.  One technique to overcome this is to dice the rib cartilage and wrap it with fascia (DCF) to augment the bridge of the nose.  Since the rib is no longer a single piece, but rather a construct created with diced cartilage, there is no memory in the rib and no proclivity to wrap.

Ronald J. Edelson, MD · Answer

Rib cartilage graft is a good procedure forbuilding up the bridge especially  in Asian rhinoplasty. However it is difficult to get it to look natural. Many rhinoplasty surgeons don’t perform so you need to search out somebody who has a lot of experience in the procedure and lots of cases to show you.

Sean Fisher, MD · Answer

Any time cartilage grafts are used there can be a risk of warping, however it is highly dependent on what is used, the way it is processed and the technique used during the operation. Different techniques can be used to minimize this risk such as using diced cartilage for dorsal augmentation as compared to an onlay sheet graft. The specific technique recommended and used will be highly dependent on what your goals for surgery are (dorsal augmentation, de-rotation, increased projection etc). What purpose cartilage graft is utilized for will dictate the manner that it needs to be prepared and as a result the risk of warping.
Sean Fisher Aesthetic Plastic Surgeon

Jin Joong Kim, MD · Answer

Hello and thank you for your question!
Being a difficult procedure it is hard to guarantee 100% the result of the surgery, seeing more surgeons and comparing they approach can help you deciding which is the best choice for you. 
Good luck!

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and unfortunately there are no guarantees in life but in the hands of an expert you should get an excellent result.   so go on some complimentary consultations with experts and compare recommendations after a full examination and discussion of desired results Dr Corbin

I'm considering rib asian rhinoplasty, but scared of its possible warp. Is there a way to assure me this can be prevented?

Answers (7)

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