Adding Rib Graft to Make Nose Bridge Larger?

The role of rib grafts in rhinoplasty is to add significant dorsal augmentation, projection, and for reshaping especially in ethnic noses or secondary rhinoplasty. This does require an additional donor site. It has some discomfort, but it is overall a good operative procedure that must be done in the hands of an experienced rhinoplasty surgeon.

In revision rhinoplasty, it is usually necessary to reconstruct and reshape the nasal framework using cartilage grafts. Because available septal cartilage has usually been removed during the first surgery, grafts must obtained from another site - either the ear or the rib.
Rib cartilage has many uses and advantages in revision rhinoplasty. It can be carved or shaped to the desired configuration. Its rigidity can provide support to a weakend nasal framework. It works particularly well for building up (augmentation) a low bridge.

Cartilage grafts are often used to rebuild the nasal bridge in cases in which too much was was taken during a previous surgery. Although rib cartilage may be required, most surgeons use this in cases in which other sources of cartilage (septum or ear) are not available. If it is needed, it can be an excellent choice, however, the surgeon must be experienced in order to prevent potential complications.

Yes, a rib graft can provide autologous (your own) support and contour enhancement to your nose. I use rib grafts when local resources are either depleted or their harvest would destailize the infrastructure of the nose. I prefer nasal septal cartilage but in many of the revisions I perform, the septal cartilage has already been used. I therefore typically move to the ear as a source, unless the ear cartilage is not adequate.
My advice is to find a board certified Plastic surgeon with extensive exprience with reconstructive/revisionary cosmetic nasal surgery. Have them take a look and advise you accordingly.
Good luck!
Dr. C

The nasal bridge (a.k.a. dorsum) can be augmented with cartilage. Most commonly, this cartilage can be harvested from the nasal septum or the ears. If more cartilage is required or these sources are depleted, rib cartilage is the next (last) source. Some surgeons like bone (i.e. from the skull) or cadaver cartilage. Artificial materials can be used (Goretex, silicone) but I usually recommend avoiding these non-biologic materials in the nose.

 There is rare need for  a rib graft. You can make the nose much larger using septal and ear cartilage grafts along with soft tissue.

Yes rib grafts are commonly used to augment the nasal bridge. Traditionally this is rib cartilage. Less often, the hip bone (iliac crest) or skull (calvarium) can also be used for recontruction of the bridge.

Since you have already had a reduction rhinoplasty, it is best to wait at least a year before embarking on further rhinoplasty procedure. If indeed you do want the nose larger, there is a way to add cartilage to the nose to build up the bridge. The first alternative would be to use nasal cartilage, and the second alternative would be to use ear cartilage, and the third alternative would be a rib graft. It is impossible to make the nose too big, and there are limitations to the skin envelope of the nose. If too much cartilage is placed in there, the blood supply to the skin gets compromised and necrosis can ensue. It is important to not place too much tension on the skin.

If the bridge of the nose is flat or low, then a cartilage graft can be used to augment this area.  There are always limitations to how large a graft can be put in becuae of the skin envelope.  A rib graft is usually best if a large graft is needed.

Hi, rib graft can certainly be used to augment the bridge of the nose. We also use the septum and sometimes cartilage from the ear. You can go larger, but keep in mind that your skin will only tolerate so much underneath, so there is a limit to how large you can go in that sense. In some cases, the nasal tip is very large in relation to the rest of the nose, and this makes the dorsum of the nose seem small. In that case, you might just need to have the tip reduced. in any case, you should find someone qualified and experienced in your area who can discuss your desires with you. Good luck! /nsn