Do ear grafts lasts forever in rhinoplasty?

Question

When ear/rib grafts are used in order to lengthen the nose and widen the tip, do they last forever? Or do they need to be replaced in a revision rhinoplasty as the patient ages? Since natural noses drop too with age is there the possibility of the grafts to "slip" out of place or to loosen and make the nose look irregular or unnatural so that a revision would be needed?

Kenneth Hughes, MD · Answer

The tissue is living tissue; providing the graph takes, it should be permanent.  A revision is not needed as you age and the skin on your nose thins.

Jonathan Kulbersh, MD · Answer

Very good question. Grafts used in rhinoplasty tend to be very durable, no matter what the source. While there is a small chance of warping or other changes following the surgery, the cartilage becomes integrated with the rest of the tissue over time. It is very unusual to experience changes many years later. Make sure you are working with an experienced, board-certified plastic surgeon to ensure an optimal outcome. Discuss your concerns with your surgeon and it is likely your doctor will be able to put most of your concerns at rest before your surgery.

Ronald Schuster, MD · Answer

Cartilage is the most common type of graft used in rhinoplasty (the others being fascia, skin and bone). The sources of cartilage include septum, ear and rib. Most surgeons use cartilage taken from the patient at the time of surgery though it is also possible to use cadaveric cartilage that has been appropriately processed. Once the cartilage is incorporated it generally is permanent. However, different types of cartilage when placed in different places can bend or change in shape due to the forces of scar tissue and aging. Experienced rhinoplasty surgeons try their best to secure the grafts into position to reduce the chances of changes later. The grafts don't typically get absorbed and dissapear unless there is infection or exposure.

Pejman Aflaki, MD · Answer

Hello and thank you for your question. Cartilage grafts are commonly used for structural support in primary and revision rhinoplasty. Generally speaking, these grafts are stable and will be permanent, although there is a small risk of warping and resorption, depending on the source of cartilage and the surgical technique. My best advice is that you discuss your concerns and aesthetic goals with a board-certified plastic surgeon with extensive experience in performing rhinoplasty. I would ask to see before and after pictures of their real patients. It's important that you trust your surgeon's skills and ability to achieve the results you are looking for. In particular, pay attention to your surgeon's experience with rhinoplasty. Best,
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Gurkan Kayabasoglu, MD · Answer

Hello, 
Thank you for your question. A well and professional executed rhinoplasty procedure does not require revision cases for later years. When it comes to graft materials, autologous (ear, rib, septum) are used to reconstruct the nose. Rib cartilage gives much stronger support to the base structure of nose and ear cartilage,  primary purpose of its use is to cover the tip of the nose for a natural appearance. As a triple board certified facial surgeon, unless the surgery is performed by an expert, your result might fail.
Best of Luck, Kind Regards,

Michael A. Epstein, MD, FACS · Answer

Autologous cartilage (cartilage from your own body) taken from your ear, septum, or rib are great sources for grafts that can be used to augment, reconstruct, or support the nasal skeletal framework during rhinoplasty surgery because they are natural and will usually last your lifetime.  Occasionally, they can warp or grow just like the cartilage that is already a part of your nose.

Eric M. Joseph, MD · Answer

Cartilage grafts used during rhinoplasty are permanent, especially septal cartilage and ear cartilage grafts. I have operated on noses with cartilage grafts placed years prior, and they look "like new" and may be repurposed during revision rhinoplasty. I do not think they shift, though rib cartilage has been reported to warp in some people. Hope this helps. Dr Joseph

Zoran Potparic, MD · Answer

Cartilage grafts used in nose reconstruction (ear, septum, rib, cadaver cartilage) are stable and do not change significantly in the course of years. In other words, cartilage placed during rhinoplasty do not have to be changed ever. In the course of surgery, cartilage grafts are fixed with sutures to another stable structure or placed in tight pocket to avoid displacement. Hope this helps.

Ronald J. Edelson, MD · Answer

Cartilage grafts in the nose tend to last quite well.   However as you mention they can shift out of position.   they can also warp and become noticeable with time.  Cartilage grafts have their place in rhinoplasty mainly for revisions. I don’t think it’s a great idea in primary or first time rhimoplasty because there are risks involved and usually not necessary.

Philip S. Schoenfeld, MD, FACS · Answer

Forever is a very long time!  When a rhinoplasty is performed successfully then the grafts will continue to support your nose for many years.  There is a potential for warping of the grafts but this would happen early in the post operative phase.  Otherwise, no graft replacement would need to be performed.