Do septal extension rib grafts feel natural?

Question

How to septal extension grafts made of rib feel? Do they make the tip noticably harder? Will a significant other be able to notice it? Is the nose and tip atleast somewhat flexible? Is it noticably stiffer than a normal nose?

Steven J. Pearlman, MD, FACS · Answer

There are very specific indication for a septal extension graft especially from rib cartilage. They can increase tip projection and support a weak tip, they also can be used to lengthen a short nose. You are correct, they do make the tip feel stiff. So, they aren't always used, but when necessary there are some drawbacks. You should discuss these with your surgeon.

P. Daniel Ward, MD · Answer

Septal extension grafts are a great way to help provide good tip position. I perform them frequently and also frequently use rib cartilage for them. They certainly let add some firmness to the nose, but having a patient notice or care about the extra support is rare. In other words, I think that the downside of a little extra firmness of the tip is very much outweighed by the benefit of the improved rhinoplasty results.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  Septal extension grafts can be a  effective way to lengthen the nose.  There are several options for this.  Thin rib can be designed to have a more natural look and feel.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Philip Michael, MBBCh, FRACS, FRCS(Ed) · Answer

Dear Kuva
Thank you for your question. Rib grafts are very useful as they provide a good bank of cartilage for reconstruction. However, as you mention, they can create a very stiff nasal tip. While other grafts such as a septal graft tend to soften with time, the effect is less so with a rib graft. As regards a significant other, it is not usually visibly noticeable when having a rib graft but patients report that when noses contact such as when kissing, it is more noticeable. Best Wishes.

Edwin F. Williams, III, MD · Answer

Hello and good question! Often it is necessary to use rib cartilage if the patient has had previous rhinoplasty or septoplasty surgery, or the surgeon feels that there may not be enough cartilage in the septum to build-up the structure of the nose as necessary. The rib cartilage tends to be a little more "sturdy" than cartilage found in other areas of the body, but this does not necessarily translate to a different or undesirable outcome (i.e. stiff/firm nasal tip), and no one should be able to tell a difference just by looking at you. In fact, rib cartilage can be more desirable because it tends to hold up over time. That being side, it is normal for the nasal tip to feel more firm and maybe somewhat numb right after surgery and this is just the nature of the surgery (no matter what type of cartilage that is used). Hope this helps!

Jeffrey Epstein, MD, FACS · Answer

The caudal septal extension graft-  whether from septal or rib or even ear cartilage-  is the most powerful technique for creating the most aesthetic tip that will not change with time.  The tip will feel somewhat more firm, but despite the fact that I use these grafts on three patients every week on average, I cannot remember the last time I had a patient complain about that.

Do septal extension rib grafts feel natural?

Answers (6)

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