For Revision Rhinoplasty is it best to use own rib or donor rib?

Question

Hi I am interested in Revision Rhinoplasty I have went to couple of consultation and some doctors suggested own rib and others donor rib Which one is good for asian flat nose?

Jeffrey Lisiecki, MD · Answer

I prefer donor rib to own rib.  Both are reasonable and it is up to your and the surgeon's preference, but harvesting your own rib means a scar on your chest, additional postoperative pain, and a risk of pneumothorax.  If you are a small person or depending on your age, there is a chance your own cartilage won't be of the best shape or quality for revision surgery.  There is also some data suggesting less warping of donor rib.

Nima Shemirani, MD · Answer

Hi @Peaceful98676!  Rib harvesting is sometimes necessary in revisions if the septum and supporting cartilage of the nose have been weakened. This will give more strength and support to the nose. Autologous rib grafting is preferred. Best of luck, Dr. Nima!

Ajaya Kashyap, MD · Answer

Thank you for your query. Rib cartilages are excellent material for augmentation rhinoplasty. When comparing your own and  cadaveric  ribs for rhinoplasty, it is your own (autologous) rib grafts  that are generally preferable..Please find an experienced Board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

Jeffrey H. Spiegel, MD · Answer

I'm glad you are thinking of a rib graft over a synthetic implant. Many Asian rhinoplasties are done with a silicone implant, but, they have a higher infection rate.
Rib can be used for sure as a nice and perhaps safer alternative for the long run.  The best studies now suggest that your own rib and donor rib have similar outcomes, and both are very safe.  So, you can simply decide if you are comfortable with a donor rib, or if you would prefer a small incision under the breast.  These procedures usually take about 1 to 1 1/2 hours at our center.
Watch our videos to learn more.

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

Hello! Great question. This topic stimulates some debate between surgeons. I prefer to use your own rib as the rate of infection is lower and it's more compatible with your own tissues since it's yours. There is a risk of warping with younger patients as less calcium exists within the rib (helps provide rigidity). Donor rib is not living tissue so-to-speak and that bothers some patients. For Asian patients with flat noses, rib is needed and your own provides a plentiful source in most cases. Look at the pros and cons of each like you're doing. Hope this helps!

For Revision Rhinoplasty is it best to use own rib or donor rib?

Answers (5)

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