Rib or Ear Cartilage for Rhinoplasty?

I have had two rhinoplasties already. I have no more septum left to rebuild my nose tip. Which is better to use for this: rib or ear cartilage and why?

Doctor Answers 4

Ear cartilage is my first choice.

The reason experienced rhinoplastic surgeons use more ear cartilage grafts than rib is that we feel that ear cartlage is easy to get, minimal discomfort, no cosmetic deformity, can be taken with skin, cheaper to do, etc. If both ears have been used, then I use rib. 

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

You need to see a super specialist who has a wealth of experience with redo noses

The choice of ear or rib cartilage is very dependent on what needs to be done. When you are embarking on your third rhinoplasty you would be better served to consult numerous board certified plastic surgeons before you decide. Make sure you ask about the surgeon's experience with revision rhinoplasty. Many plastic surgeons shy away from rhinoplasty, few have a wealth of experience with revision rhinoplasty. Get numerous opinions, see many photos of before and after patients. Get a feel if the surgeon you are choosing can deliver what you hope to obtain.

Then let the surgeon decide wether the ear or rib cartilage is best or many be a skull bone graft. It all depends on your condition and the surgeon's experience.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 reviews

Rib graft is straighter, ear graft is thinner

Without a picture, it is somewhat difficult to understand what is planned. In general, rib cartilage is straighter, stiffer and utilized for the dorsum or potentially as a strut to reinforce the tip. The tip proper can have projection enhanced with either graft. As an onlay graft, the ear may provide the better choice as its thickness is more in keeping with what is necessary in most tips. Likewise, the donor site issue is less.

Discuss this with your surgeon, and be mindful that each additional rhinoplasty intervention deals with increased scar and less predictability.

Hope this helps.

Michael A. Marschall, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 9 reviews

Type of cartilage for Rhinoplasty depends on your needs

Ear cartilage is more difficult to sculpt then rib cartilage, but has less chance of warping. Rib cartilage is plentiful and easier to sculpt but may warp. If you need a lot of cartilage then I typically use rib or goretex which is an implant with a very low rate of complications. I however rarely have to take rib cartilage and can usually find some septal cartilage to work with even after multiple revisions, and with ear cartilage can usually fix whatever is the issue. Hope that helps.

Samson Lee, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.