Question Regarding Rhinoplasty to Raise Nose Bridge?

Thank you for your question. It sounds like you have been doing your reading. The cartilage used in the nose for grafting will not turn into bone but with age rib cartilage can calcify and therefore theoretically could if placed in the nose. This should not be a significant concern for you but you should understand that when cartilage is added to build the bridge or add support it will change the feel of the nose and it will become firmer. Some of these changes need to be accepted if you would like to change the appearance of the nose.  Best of luck!RegardsDr Guy Watts

Grafted cartilage during rhinoplasty normally stays as cartilage rather than turning into bone. Cartilage is still rather firm and being placed under the nasal skin it doesn't really feel any different than bone.For bridge augmentation the only place in the nose where cartilage can be harvested from is the septum. Like you mentioned, the ear or rib are other non-nasal sources of cartilage as well.You can read more about nasal bridge augmentation at my web reference link below.

The cartilage should not become bone. The cartilage can be taken from the bridge and the septum as well. The cartilage can be weakened and made to feel softer.Find a plastic surgeon with ELITE credentials who performs hundreds
of rhinoplasties and rhinoplasty revisions each year. Then look at the
plastic surgeon's website before and after photo galleries to get a
sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

Nasal septal cartilage is the most common source of cartilage. For 35 years I have used this without problems. Rib cartilage is painful and MUCH more expensive.

Augmentation of the nasal bridge is usually accomplished with patient's own nasal cartilage first. If there is simply not enough nasal cartilage present, then the ear cartilage can be considered. Nasal and ear cartilage should not become ossified with time. Rib cartilage can become hard, stiff, and ossified like bone which is a natural healing process. For many examples please see link below to our rhinoplasty total gallery

Cartilage does not turn into bone but may calcify and harden with time. Usually, the cartilage graft feels softer than the underlying bone, but still feels firm. Cartilage that is taken from the nose is usually taken from the septum or midline of the nose. The septum can yield a pretty large flat piece of cartilage but lacks the height that is usually needed for bridge augmentation. If septum cartilage is used, it is often diced and placed into a rolled piece of fascia (muscle lining) like a sausage. This is then inserted underneath the nasal skin. Rib cartilage is a graft I like to use and has less tendency to lose height with time. The graft can warp (or bend) and needs to be properly handled before inserting it. If not camouflaged appropriately you will be able to see the edges.

There are no one best way to do this. Each surgeon may use different materials.The key is to find a surgeon that can achieve what you want and have a low rate of complications with the material used.Personally, I prefer donor rib cartilage. It can be sculpted to each patient's surgery, it incorporates well, and has a very low rate of infection.Any type of material used will be palpable under the skin, but you will not feel it unless you touch it.

You have mentioned the areas that cartilalge can be taken from to build the dorsum. The three major areas are the septum, ear and rib. One can also use irradiated rib cartilage taken from a cadaver that acts just like your own cartilage. I have also used bone taken from the hip (painful) or outer table of the skull. All act and feel like your natural dorsum if done properly.Dr. Corbin

When we are adding to the dorsum or bridge of the nose we
call this an augmentation rhinoplasty.
There are a number of ways to accomplish this or a number of different
options that can be used. These include:



Filler: The fillers
can work very well to augment the nose. I
prefer Bellafill since it is a long term (5 years minimum) solution. If there is a lot that needs to be added
there are better substances.



Nasal Implant: The
most common is a silicone implant and this is used around the world but
especially in Asia to augment the nose. One
implant that works very well is the porous implant made by Medpore. It becomes part of your body and can be
shaped or carved to customize to your body.



Cartilage: This can
be harvested from your nose, which is common, your ear which is not as common
or your ribs whenever we need cartilage for augmentation or shaping your
nose.



Bone: This is probably
the least common and is use when we need a lot of material for the nose. This is usually used for major
reconstructions.



It really depends on your needs and your goals as to what is
best for you. You are advised to see an
experienced Board Certified surgeon to determine what is best for you.



I hope that helps.



Best regards.

Cartilage used to augment the bridge will always remain cartilage - it will not become a different tissue. After the nose has healed the graft will not be palpable. Any cartilage removed to reduce the size of the nose can be incorporated into graft.