Donated rib cartilage vs my own rib cartilage for Asian rhino?

Question

Though it is not coming from my own body, is having a donated rib cartilage still a better option than silicones and other manmade implants for an Asian rhino? What are the major drawbacks of receiving donated rib cartilage for bridge augmentation?

Edwin Kwon, MD, FACS · Answer

Having utilized cadaver rib for both support grafts and bridge augmentation with diced cartilage fascia in patients who do not want to undergo rib harvest for the past two years, they have held up well so far.  What's not clear is what the long term effects will be over decades.

Kenneth Hughes, MD · Answer

Cartilage can either come from the patient's ear or rib or from a cadaver.  If the cartilage is harvested from the cadaver, it is radiated to make sure there is no chance of any kind of transmittable disease. The benefit of using the cadaver cartilage is that it saves time and the extra healing that is involved with taking cartilage from the patient’s ear or the patient’s rib.  If rib harvest is your only option, this harvest is not insignificant and has complications of its own such as warping and pneumothorax.  I typically use septal and ear cartilage, but it you need rib cartilage it is better to use your own.

William Lao, MD · Answer

Donated rib cartilage is a good choice for people who do not want an incision on their chest and also don't want to use implants. The biggest drawback for donated rib is the unpredictable absorption. Since it is not part of your body, it can undergo absorption and lead to future shape change.  So when consider using donated rib, it is probably best to combine it with some native cartilage material from your septum or ear to mix it up a bit.

Donald B. Yoo, MD, FACS · Answer

Using autologous grafts (tissue and cartilage from your own body) will provide the safest and most permanent results.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.

Sean Fisher, MD · Answer

Many surgoens elect to use cadaver rib over a patient's own rib with very good results. Both can provide acceptable results and the decision will be based on your anatomy, specific needs of your surgery, and patient preferences. I would consider rib graft, whether cadaver or autologous, to be superior to silicone onlay as there is less risk of infection or extrusion over time. 
Sean Fisher Aesthetic Plastic Surgeon

Hong Ryul Jin, MD · Answer

If you compare these two, I prefer autogenous one. Donated rib is just a framework and the chondrocytes are all dead. Resorption is not predictable at all, varying from little resorption to severe resorption. Because you don't know the original cartilage quality where it came from, you cannot predict the resorption. It also needs thicker slice compared to the autogenous one when you want it for support or splinting purposes, and this makes the tip or columella thicker when you use to modify the tip. It may be better than silicone but definitely autogenous one is better if you want to avoid alloplast. Thanks.

Mark Ginsburg, DO · Answer

There are 2 schools of though when it comes to rib cartilage.  On is that your own tissue is best and more long lasting and the cadveric rib is more prone to absorbing.  There are also some long term studies showing the efficacy and reliability of cadaveric rib.  In my mind either of these is a better option than a synthetic implant.  Synthetics have been used with success as well, but I feel that anything synthetic has a higher infection, capsular contracture and extrusion rate than rib cartilage.  The advantages to your own rib are that it is your own tissue and potentially more resistant to breakdown and infection, though, these are risks with both types of rib.  The downside to your own rib is increase in surgery time, cost and risk of complications from harvesting the rib, namely rib pain, scarring and a small risk of punctured lung.  The advantages of the cadaveric rib are that it does not increase surgical time or cost and does not have the donor site morbidity( the risks named above).  Best of luck!

Richard W. Fleming, MD (retired) · Answer

Although it is a much easier procedure I don't recommend silicone grafts to augment Asian noses because of the increased risk of infection, movement or extrusion. I prefer using the patient's own tissue but I rarely need to harvest from the ribs; I find septal and ear cartilage adequate.

Donated rib cartilage vs my own rib cartilage for Asian rhino?

Answers (8)

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