Revision Rhinoplasty - rib cartilage or fascia?

Some of the options for bridge or dorsal augmentation in rhinoplasty or revision rhinoplasty include solid carved rib grafts, diced cartilage wrapped in temporalis fasica, diced cartilage formed into a solid implant with tissue glue, synthetic implants such as gortex. IF its only a small amount I may use two or three layers of temporalis fascia. The choice really depends on how much you are looking to augment among other issues. It's best to speak with a revision rhinoplasty specialist to see which options are best for your specific needs.

If a patient’s bridge (dorsum) needs to be augmented/built up, a few options exist. The patient’s own cartilage is most commonly used. Septal, ear (conchal), and rib (costal) cartilage are all options. Irradiated/sterilized cadaver cartilage can also be used. Each have relative advantages and disadvantages that should be discussed with your surgeon. Septal cartilage is used most commonly. Cartilage may be diced and placed within a thin connective tissue sheet (temporalis fascia) in a tube shape as well. Fascia by itself is generally used only in thin skinned patients to avoid irregularities. Good question. Discuss these issues with your surgeons. 

The best source of cartilage for reconstructing the nose is always going to be nasal cartilage. If there is a cartilage depleted nose, then consider ear cartilage. Fascia taken from the scalp can also be used. Harvesting rib should be your last resort.