Hi, I had a septorhinoplasty 2 years ago and I am going for a revision now (the doctor will use ear cartilage to build my nose and to make it look straighter).I have some guestions about that : 1)Can ear cartilage warp? How will that affect the nose (will the nose become more crooked) ?? 2)Can ear cartilage become visible under the skin? 3)Can it extrude? 4)And what to do in these cases?Can I undergo another revision to remove the ear cartilage from my nose ??
Possible Risks of Using Ear Cartilage in Revision Rhinoplasty ?
Doctor Answers 5
Ear cartilage is a great choice for reconstructing the lower lateral cartilage. It is a poor choice for any doral or tip support work. Any graft can show after placement if not done with talent and extensive experience in these difficult cases. All cartilage grafts shrink to some degree and must be placed in slightly oversized. All cartilage grafts soften over time so offer very little support. Ear cartilage is great for reconstruction of the lower lateral cartilages because of its natural curves and thin nature.. In the dosum of the nose it offers no support and with eventual shrinkage will always be visible so is a very poor choice in this area.
Risks of using ear cartilage in Rhinoplasty?
I have performed Rhinoplasty for over 20 years and yes, the risk of using conchal ear cartilage anywhere but for the nasal tip, IMHO is that it can warp and dissolve unevenly years after the Rhinoplasty. This can cause marked indentations and asymmetries, crooked section of the nose requiring a more stable, reliable graft such as a straight silicone implant. For these reasons, I do not use ear cartilage, rib cartilage/bone, or cranial bone for the nasal bridge. I only use the straight silicone implant. I do only use ear cartilage for tip gratfs were it has none of the issue mentioned above. Hope this helps.
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Ear cartilage is a great material in revision for cartilage depleted noses. Using your own cartilage avoids the risks of implant rejection/infection. It does not resorb. It does not extrude. All cartilage has risk of showing through the skin if not carved and smoothed meticulously. Your result will depend on the execution of your surgeon not the cartilage.
Ear cartilage is safe and reliable
You ask some important questions about the use of ear cartilage in rhinoplasty. In my practice and experience I find that ear cartilage is used ideally in three areas. Ear cartilage is naturally curved which makes it great for rebuilding or strengthening the sides of the nose if there is collapse or weakness. It also can be used to rebuild a nasal tip in cases where the natural tip cartilage are damaged or have been removed. Finally, the perichondrium that covers the ear cartilage makes a great graft for the bridge of the nose. For everything else I prefer to use septal cartilage or rib. The risk of extrusion with ear cartilage is low, it is a living tissue graft and is very safe. It can show through the skin in thin skinned patients if the graft has not been secured and shaped properly. It can be removed if it is no longer needed or wanted. As far as warping, it is already curved in shape so yes it can warp.
I hope this helps.