I'm an Asian girl considering Rhinoplasty to give my bridge more height and definition. I want to use autologous grafting. Which material is best for augmenting the bridge -- ear, septal, or rib? Since I only need slight augmentation, a doctor recommended ear cartilage. However, I have read that ear cartilage is naturally curved and prone to bending. What about septal? Is there enough septal cartilage for augmenting the bridge? Which material has the best results with the lowest risk of complications such as warping and resorption?
Best Material for Augmenting Nose Bridge?
Doctor Answers 4
Rhinoplasty Material to Augment Nasal Bridge
As others have already stated, your own tissue is the best material to use for rhinoplasty. Silicone implants in the nose are more likely to become infected and may extrude.
Cartilage is available from many places in your body for nasal surgery. However, there isn't a best material - ear, septal, or rib cartilage. Each tissue has its own strengths and weaknesses. The material used is largely based on the plastic surgeon's and the patients preference. Keep in mind that all tissue used in nasal surgery may warp, bend, or reabsorb.
Most rhinoplasty surgeons prefer to use septal cartilage. In Asian rhinoplasty patients, the septal cartilage may be thin or insufficient for nasal augmentation. As a result, many Asian rhinoplasty surgeries involve ear cartilage.
Only after a comprehensive evaluation can a rhinoplasty surgeon determine the most ideal material for you. Best of luck.
Diced cartilage and fascia for Asian Augmentation Rhinoplasty
My preference for any rhinoplasty to is to use the patient's own tissue to create a new nose. I especially like my technique of diced cartilage with deep temporalis fascia to create a new bridge in the Asian patients. In fact, I have corrected the silicone implant problem many times with this techinique.
In more than 30 years of rhinoplasty, I prefer using septal cartilage with or without soft tissue covering in my Asian patients. If it is a secondary nose without enough septal cartilage, then I go to the ear. Rib is my last choice.
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There is no best material; it's what is best for you
Cartilage is a fantastic material for augmenting the nasal bridge. Each of the cartilage sources you mentioned has its advantages and disadvantages. Septal cartilage is ideal since it most reflects the natural cartilage of your nose. But, there is often very little available for use in Asian patients and what is there is often a little flimsy. On the other hand, if you only need slight augmentation, there might be just enough to work for you.
Rib cartilage is often used for nasal augmentation when a lot more volume is needed. It is strong and plentiful and can create a nice contour. But, there is a small risk of warping and it tends to feel hard and 'blockish'. If slight augmentation is all you need, rib is probably overkill for you.
Ear cartilage works very nicely for augmentation. It is soft and pliable and provides some support but not nearly as much as rib. Thankfully, augmentation of your bridge is probably being done for aesthetic contour purposes only, not to provide missing support. You are right, there is a natural curvature that can be overcome by shaping the cartilage. And, surgeons experienced with ear cartilage do not generally have issues with it bending down the road. We've had wonderful results over time with ear cartilage for Asian rhinoplasty.
So, as you can see, there is no perfect material. The question really is which one is perfect for you. The other thing to keep in mind is whether you may need grafts to augment or provide support to your tip. Your doctor may choose to use your availabe septal cartilage for that purpose instead. It all boils down to how much you need versus how much of a particular graft material is available. I would advise you to see a surgeon who is proficient in augmentation rhinoplasty using multiple materials and techniques because no one technique is right for everyone.
All the best for a great result!