Solid rib vs. DCF, which is more reliable for a long lasting result?

Question

I’m researching revision rhinoplasty to augment an overly resected nose following dorsal hump removal. In addition to dorsal augmentation I need tip projection added. I am looking for a taller, narrow bridge. Which can provide a narrower taller bridge? DCF or solid rib? Which is more reliable and less likely to warp/need further revision? DCF or solid rib?

Alejandro Nogueira, MD · Answer

-diced cartilage wrapped in fascia (aka Turkish delight): has become popular in the recent years, is simple and technically easy, besides short in surgical time, thus tempting, for surgeons with limite skills sculpting rib cartilage; I advise you, severely, against it: high rate of complications, infection, resorption, cystic evolution, jelly palpation, shape dents, weird touch feeling, irregular dorsum, visibility, etc-rib cartilage: harvesting with care the rib cartilage, meticulously closing the donor site, sculpting the dorsum out of the harvested block, performing dozens of tests and adjustments and its fixation takes minimum 2 hours of surgical time, plus the rest of the gestures of the rhinoplasty; it is a very creative option, you can literally buil the dorsum you wish, whatever is the technical or aesthetic need or preference it can be shaped, is lifetime lasting, natural looking and feeling, stable, safe, but... terribly demanding for the surgeon; if properly harvested does not warp ever, the cortex warps and has to be discarded, the core shaft remains stable and straight, and always the 7th or 6th ribs are the best options, not the 8th which is the floating one, easier to harvest but curvyNow a quiz: which option you think is majoritary among the community of surgeons dealing with revisions of scooped noses or flat ethnical noses? (I don't include in the comparison the synthetic prostheses)You are right, the diced cartilage wrapped in fascia.Rib cartilage noses are pure masterpieces of creativity and surgical artistry, see examples in the link below.

Sam Naficy, MD, FACS · Answer

In general solid cartilage has less resorption (loss of volume) but is more likely to warp if proper technique is not used.  With proper measures, solid rib grafts can stay very straight.

Solid rib vs. DCF, which is more reliable for a long lasting result?

Answers (2)

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Solid rib vs. DCF, which is more reliable for a long lasting result?

Answers (2)

Browse related questions

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.