In a revision rhinoplasty procedure, cartilage is needed in order to straighten out asymmetries, add strength and often rebuild tissue that was removed. The cartilage can be harvested from the nasal septum (if any remains), the ear or the rib. Other harvest sites are uncommon.
Typically patients feel minimal pain after rhinoplasty. There is some mild discomfort after a ear graft harvest so patients are more aware of this than their rhinoplasty. This discomfort responds well to pain killers and is generally not a big deal for patients.
The scar for an ear cartilage graft is typically placed in the crease behind the ear. The ear typically looks almost identical to how it looked before surgery. This is because the part of cartilage which is removed is not important to the overall shape of the ear. The ear is usually well healed at a week after surgery.
If your surgeon has elected to use an ear graft it probably means that you need it. I would not be put off by some of the concerns you raised. An ear graft is a fairly routine procedure that is well tolerated by patients.
It is quite common to need additional cartilage when doing a revision rhinoplasty. Which source of cartilage, the ear or the rib, is chosen depends on the deformity that needs to be corrected. If the nose is too small, over resected or collapsed then it is more common to use rib cartilage to create structure and support. If there are subtle asymmetries, particularly in the tip, ear cartilage is an excellent alternative. The donor site with both rib cartilage and ear cartilage should not be particularly painful. There is discomfort and tenderness but seldom severe pain. If the cartilage is harvested properly deformity of the ear should not occur. Your doctor has given you excellent advice for the management of a subtle deformity of the nasal tip or possibly dorsum. If the nasal deformity is significant additional cartilage may be necessary. Be sure to discuss your concerns with your surgeon
Not every revision rhinoplasty requires cartilage grafting techniques. In our rhinoplasty practice, we use nasal cartilage first, before electing to harvest ear cartilage. When ear cartilage is used, a small incision behind the ear is inconspicuous and heals quite well with only minimal amount of pain.
cartilage to use for grafts in rhinoplasty is the septal cartilage from inside
the nose. However, in revision
rhinoplasty, the septal cartilage is often not an option because it may have
been already used in the previous surgery. In this situation, cartilage from the ear is a good substitute. It can be removed through an incision hidden
in the curves of the ear that heals inconspicuously. If a limited amount of cartilage is harvested
from the ear carefully and from an appropriate location, it will not affect the
appearance of the ear after surgery at all. That portion of the ear may feel
less rigid than before but will not look any different. Some patients do experience more discomfort
from the ear cartilage harvest site. This is treatable with pain medication and
always resolves. After surgery, it is
common to have a bolster dressing sewn to the ear to prevent a hematoma or
blood collection. This dressing and the
sutures are removed at about a week. The incision on the ear should heal
inconspicuously in a few weeks.