Is ear cartilage better than rib cartilage for a rhinoplasty if someone has thin skin?

Question

I had a consultation with a surgeon for a rhinoplasty and he said that I would have to have ear cartilage taken because I've had a septoplasty done before. I have thin skin and I'm worried ear cartilage will show.

Stephen M. Krant, MD, FACS · Answer

Ear cartilage is a safer bet than rib cartilage. It can be shaped, sculpted, softened to give you the contour you need. Also, it can also be "crushed" to act as a filler on top of the cartilage graft to make it less noticeable! Ear cartilage is definitely the choice I would use for your reconstruction. The recovery is also definitely easier.
Good luck!

Eric J. Yavrouian, MD · Answer

When septal cartilage is unavailable, rib or ear cartilage can be used for grafts. The decision as to which depends on the amount of cartilage needed and the strength/type of grafts needed for the rhinoplasty. Rib cartilage is useful when in need a larger amount of grafts and those with greater strength. The thickness of the skin does not affect the source of the cartilage used; it alters the types of grafts placed. Thank you for the question. Good luck with your surgery!

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well.. based in your question its difficult evaluate you if the case dont have a picture, its recommended if you get a consultation in person with a plastic surgeon to discuss all about theme.

Jeffrey Joseph, MD, FACS · Answer

In most of my revision rhinoplasty, I use grafting for both cosmetic and functional purposes.  Whether you use ear or rib depends on surgeon preference and for what purpose the graft will serve.  Good luck!

Steve Laverson, MD, FACS · Answer

The answer to your question depends on how the graft is managed and many technical factors.  Ear can show and rib can show, but they can also both be successfully used without showing.  Thickening your skin to help prevent, camouflage, and cover visible irregularities can be accomplished with acellular dermal matrix over the graft, Galatea mesh, fat grafting, dermal graft, and others.  Alloplast (porous polyethylene) is also a proven choice for low profile highly supportive tension free nasal grafting, but must be well covered by healthy vascularized tissue.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  It really depends on what changes you wish to make.  For example, if your nasal tip needs to be lifted, then strong cartilage such as septal cartilage (however you don't have this option) or rib cartilage is best.  Ear cartilage is not strong enough for a columellar strut graft.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Tom D. Wang, MD, FACS · Answer

Hi there, thanks for your excellent question.  The short answer is not really.  This really depends on: 1) whether you have enough septal cartilage left for grafting and 2) what specific graft(s) are needed for your nose.  Ear cartilage is softer and curved compared to rib cartilage which is generally stiffer and straighter.  Both can "show" with thinner skin so extra care will be needed in shaping and positioning them to ensure smooth contour.  Hope this helps and best of luck to you!

Jason D. Toranto, MD FACS · Answer

Thank you for your question.  In rhinoplasty, we use cartilage from either the septum, ear, and/or rib.  All of them work well when used correctly and, as you can imagine, each is a little different.  I would recommend a consultation with a board certified plastic surgeon to determine what is the best option for you.

William Portuese, MD · Answer

Just because someone has had a septoplasty doesn't mean there's no cartilage left on the inside of the nose. A thorough examination of the internal portion of the nose can determine how much is left  over after a septoplasty  for  potential grafting purposes for the rhinoplasty.

Richard W. Fleming, MD (retired) · Answer

I rarely use rib cartilage to augment the nose because it is more difficult to harvest and requires an incision on the chest. I always prefer ear cartilage if available. An experienced surgeon will place the grafts so they are not visible in a thin skinned patient regardless of where they are taken. Despite this challenge  a patient with thin skin can achieve a better more defined result.

Is ear cartilage better than rib cartilage for a rhinoplasty if someone has thin skin?

Answers (10)

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