Risks of Using Rib Cartilage for Revision Rhinoplasty?

In general the risks of rib cartilage grafting include:


Graft asymmetry or warping. With an experienced surgeon this risk is lessened significantly.

Injury to the underlying lung during graft harvest (also rare with an experienced surgeon)

stiffer nose after surgery

Poor healing of the chest incision. Ask your surgeon what length incision they use (this varies among surgeons). The chest incision typically heals very well.

risks of surgery in general such as bleeding, infection, anesthesia, etc.


Depending on your anatomy, septal cartilage and/or ear cartilage may be used. Needing a large volume of cartilage for reconstructing your bridge is often best done with rib, though.

Thank you for the great question. Using autologous (from you) rib in rhinoplasty is generally safe.  The long-term complication that is most feared with costal cartilage grafts is warping -- or shape change/curvature of the graft material over time. Certain techniques are used in surgery to limit this, but it is unfortunately not completely predictable. The other possibility is graft resorption (the grafts don't survive and the nose loses volume again).The alternatives in cases where a significant amount of grafts are needed are less appealing. With implants in the nose, there is a risk of infection and extrusion over time, in addition to the risks of settling or shifting. This is not an easy decision, but, in my opinion, using your own tissue is always better.
 

Optimally, one of the most important aspects in rhinoplasty, both primary and secondary, is to use autologous tissue if needed. These are the most challenging operative procedures that we do in aesthetic plastic surgery, therefore, it’s very important to choose an experienced rhinoplasty surgeon. Find someone that has significant expertise in secondary rhinoplasty surgery as this is a very challenging and difficult operative procedure. One can never totally restore one to a normal nose especially if you’ve had multiple operative procedures. The use of rib grafts are used if there is loss or collapse of the nose and/or tip. However, it is not without its problems including potential temporary chest wall pain and warping of the cartilage itself short or long term. I will use it in those patients where I can not use any other autologous material like septum or the ear and certainly in the dorsum if I need to augment it more than 4-6mm, I will definitely use rib.