What is the best material to build up a stronger nose bridge?

Question

What's the best type of cartilage for building the bridge? Is it ear cartilage? Is it a very difficult procedure? How big is the risk for unevenness - bumps or dents? I have very thin nose skin, could a satisfactory result be achieved(not too much unevenness)? Thanks!

Milan Doshi, MS, MCh · Answer

Hello Chilly
Thank  you for your  question. 
Dorsumcan be augmented  with  septal  ear or rib cartilage ,depending on the amount of needed cartilage.  Cartilage is diced finely and used to augment the dorsum. If skin is very thin, that can be wrapped in facia and used
Please consult with board certified plastic surgeon  and discuss in detail. 
Best  of luck. 
Dr Milan Doshi 
Mumbai

Pedram Imani, FRACS, MS, MBBS (Hons) · Answer

The best material is your own cartilage. Having thin skin means that the surgeon should use fine pieces of cartilage from either septum, ear or rib. This is not a particularly difficult operation for a well versed rhinoplasty surgeon. Unevenness is rare if super fine cartilage grafts are used. If the skin is very thin then the cartilage can be camouflaged using your own fascia such as the one covering your temporalis muscle. Depending on the reason for your low dorsal height, you may need other cartilage grafts such spreader or even septal reconstruction. Hope this is helpful.

Alexander M. Sailon, MD · Answer

Hi there,
First of all, I am glad you asked specifically about cartilage, which is superior to implants for building up the bridge of your nose. The best choice depends on how much of your bridge needs to be built up. If it is a mild to moderate increase, then diced cartilage (either septum, ear, or both) is excellent. If you need a very significant increase, then using rib cartilage may be better. Best to see a plastic surgeon well versed in rhinoplasty to help guide you through the various options. Good luck!

Mehdi Sina, MD · Answer

Hi,The best material to build up the dorsum is cartilage. Implants are also available but there is a risk of infection and shifting. In order to minimize the risk of warping and contour irregularities, the cartilage is finely diced and in some instances wrapped in fascia (fibrous sheet harvested from over the temple). Ear cartilage can be used but the amount of ear cartilage available is limited so in some instances both ears may be needed. A better source of cartilage is the septum and if the septum is not available then rib cartilage. This is certainly a more advanced procedure but when done with precision and care the risk of unevenness/bumps, etc are greatly reduced.  Good luck,Mehdi Sina, MD

Julian Rowe-Jones, MBBS, FRCS (Eng), FRCS (ORL) · Answer

I prefer using a patient's own tissue rather than artificial implants.  Grafts can be solid or softer.  Septum, ear or rib cartilage can be used depending on how much is needed and what is available. The advantage of softer grafts like diced cartilage is that the chance of a visible edge is less likely.  This cartilage can be wrapped in fascia if a lot is needed for the bridge.  If only a small amount of building up is needed under thin skin then temporalis fascia taken from the scalp is a good choice.

Ashok Govila, FRCS, MCh, MS - Account Suspended · Answer

Hi,
Thanks for a good question.
Your concern seems to  be a deformity following ear cartilage graft.If done well it does not leave any deformities of any kind including surface irregularities.
Its most simple way to collect a strong cartilage.I normally use it crushed and rapped in a layer of "surgicell"( that is a haemeostatic soft net)  and then one can give a shape to the dorsum of nose as desired looking form outside as your most wanted shape.
The worry about thin skin can also be addressed using a thin temporal fascia from scalp area above the ear. 
I wish you all the best.

What is the best material to build up a stronger nose bridge?

Answers (6)

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