Does the ear, rib or septal cartilage used for structural support like columella and alar batten grafts weaken over the years or even decades? Can one expect such grafts to literally last a lifetime?
Answer: Cartilage changes over the long term There in no question that cartilage changes over the long term. However this does not always translate to a loss of support or to a noticeable cosmetic change. I have used all forms of cartilage over the past 25 years in all areas of the nose. These are my findings......... Ear cartilage looks great and holds up nicely even over time as augmentation and replacement for the lateral crus of the lower lateral cartilage. What changes in the cartilage occur, and some do, are balanced by scar tissue formation that seems to keep the original cosmetic change present. Columella struts with septal cartilage will weaken over time, every time. However the thicker the strut the longer this takes. Eventually most nasal projection corrections will once again begin to sag from loss of support. Any cartilage put over the nasal dorsum whether it is banked cartliage, rib cartilage, septal cartlage or ear cartilage will rapidly be resorbed and/or warp and distort. The only material that lasts on the dorsum is bone and preferrably calvarian from the patient himself or herself No matter how good you look in the short term these changes will happen in the long term. I have seen people look fantastic at year three and terrible at year four. This is the reality. Artificial implants will not change over time but are 100% contraindicated because of the serious complications they will all lead to over time. NEVER use them!
Helpful 2 people found this helpful
Answer: Cartilage changes over the long term There in no question that cartilage changes over the long term. However this does not always translate to a loss of support or to a noticeable cosmetic change. I have used all forms of cartilage over the past 25 years in all areas of the nose. These are my findings......... Ear cartilage looks great and holds up nicely even over time as augmentation and replacement for the lateral crus of the lower lateral cartilage. What changes in the cartilage occur, and some do, are balanced by scar tissue formation that seems to keep the original cosmetic change present. Columella struts with septal cartilage will weaken over time, every time. However the thicker the strut the longer this takes. Eventually most nasal projection corrections will once again begin to sag from loss of support. Any cartilage put over the nasal dorsum whether it is banked cartliage, rib cartilage, septal cartlage or ear cartilage will rapidly be resorbed and/or warp and distort. The only material that lasts on the dorsum is bone and preferrably calvarian from the patient himself or herself No matter how good you look in the short term these changes will happen in the long term. I have seen people look fantastic at year three and terrible at year four. This is the reality. Artificial implants will not change over time but are 100% contraindicated because of the serious complications they will all lead to over time. NEVER use them!
Helpful 2 people found this helpful
