What is the Difference Between Septo-Rhinoplasty with Septal Cartilage Graft and Revision Rhinoplasty with Ear Graft?

What is the difference between SeptoRhinoplasty with Septal Cartilage Graft and Revision Rhinoplasty with Ear Graft? What are the consequences of removing too much cartilage from the septum?

Doctor Answers 10


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Septal, auricular and costal cartilage is the "stuff" of standard autologous rhinoplastic grafts and are used for many different reasons in septorhinoplasty surgery.  Suffice it to say: "Lend me your ear" as igraft your nose!

San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Septorhinoplasty with septal cartilage graft and revision rhinoplasty with ear graft

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Each procedure can vary depending on the needs of the patient.  Sometimes, the patient may have a deviated septum (cartilage and/or bone causing obstruction inside the nose), along with a structural issue that may be preventing the patient from breathing properly. A patient with a deviated septum may have septoplasty performed simultaneously with a rhinoplasty. This is known as a "septorhinoplasty." During this procedure, any obstructions will be removed, leaving the patient with a open airway. In addition, any necessary structural changes will be made to further improve the patient's breathing.  These changes can improve the look of the nose as well.


In regard to harvesting autologous cartilage for a graft, septal cartilage is my first choice.  But in many cases, there may not be enough available, or the cartilage from the septum may be compromised.   Rib cartilage is a great second choice. It is very strong, and much more rigid than ear cartilage.  In addition, a far greater amount can be harvested. Removing a portion of the cartilage from the rib does not affect support or structure to the rib cage. 

A revision rhinoplasty is typically performed to either modify and further perfect a primary rhinoplasty, or correct an undesirable result from a different surgeon that left the patient with a compromised nose that has structural and/or functional issues.  Again, I prefer septal cartilage over ear, and the cartilage that is harvested for a revision rhinoplasty will depend on availability and the individual circumstances of the patient. Removing too much cartilage can weaken the nasal structure and potentially result in a collapsed nose.  A conservative approach is always best. Thanks and I hope this helps!

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Cartilage grafts

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Using cartilage grafts if or revision rhinoplasty is not at all uncommon.  Septal cartilage is thicker, flat and stiff while ear cartilage is much softer and easier to contour.  Which type to use often depends on what the graft is being used for as well as the personal preference of the surgeon.  To build up  the nasal bridge septal cartilage is usually better because the surgeon can obtaina large straight piece.  Ear cartilage is better if being used to reconstruct the alar cartilage, which is the tip cartilage, because it is more easily shaped and can be curved.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

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Difference between septal and ear cartilage grafts

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Not all rhinoplasties involve only tissue removal. Some require addition or augmentation to achieve the desired result. This is more often true in revision surgery where cartilage has often been previously removed. Many surgeons prefer to use the patient's own cartilage for this. Usually nasal septal cartilage is used first and is often fairly available in a previously non operated on patient. In revision patients septal cartilage may already have been removed so the surgeon may need to use ear cartilage instead. I like to tell my patients that this is the "spare parts box" for rhinoplasty and not to be concerned about changes in ear shape.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

What is the Difference Between Septo-Rhinoplasty with Septal Cartilage Graft and Revision Rhinoplasty with Ear Graft?

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 That's a great question.  Let's first assume that the same Rhinoplasty Surgeon was performing both procedures so that they would have the same goals for nasal refinement. Then the Rhinoplasty part would be done the same and have the same aesthetic goals. One uses septal cartilage as the graft material to the nasal tip while the other uses cartilage from the ear.

 Now, much more likely is that this is what was recommend by two different Rhinoplasty Surgeons which means the purposes of the Rhinoplasty and how it's performed could be vastly different.  What remains similar is the use of the nasal tip grafting material either from the septum or the ear.  Either way, both of these procedures and what they would accomplish should have been explained to you during your evaluation and consulation with the Rhinoplasty Surgeons.  

 I have performed Rhinoplasty for over 25 years and IMHO, conchal ear cartilage makes the best nasal tip grafting material because it supple enough not to show through the skin but strong enough to give the required shape and strength to the nasal tip...it also has the proper curvature matching that of the ideally shaped Columella.  Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Grafting for rhinoplasty

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Cartilage from the septum is straighter and stronger than ear cartilage. Thus, it i.e. better suited for structural support. Ear cartilage, is better suited for tip contouring, where shape is more important than support.

Michel Siegel, MD
Houston Facial Plastic Surgeon
4.6 out of 5 stars 113 reviews

Grafts used in the nose are often taken from the septum as well as the ear

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The choice of graft source varies according to the cartilage needed, surgeon's choice and if you have had prior surgery. I prefer septal cartilage for most grafts if it is available. If you have had prior nasal surgery there may be insufficent cartilage in the septum to use as grafts as not to compromise nasal support, then I use ear cartilage. If a lot or long and strong cartilage is needed for revision rhinoplasty I then use rib cartilage, but don't feel this is necessary very often.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

What is the Difference Between Septo-Rhinoplasty with Septal Cartilage Graft and Revision Rhinoplasty with Ear Graft?

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The basic difference is septal cartilages vs ear cartilage. There are pros and cons of both. Depending on what part of the nose needs revising, septal cartilage can be superior because of its strength and shape. Ear cartilage has natural curvatures and is slightly weaker and can be used for tip grafts or butterfly spreader grafts. Your surgeon should now how much septal cartilage can be removed.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Septorhinoplasty with septal cartilage graft vs Revision with ear cartilage.

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Septorhinoplasty with septal cartilage graft vs Revision with ear cartilage is where you get the cartilage and if the patient has had a rhinoplasty before--then it is a revision. If there is enough cartilage in the septum to do what the surgeon wants then there is no need to go to the ear.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Grafts and nose surgery

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The terminology gets a bit confusing sometimes. Many primary rhinoplasties, and most revision rhinoplasties require cartilage grafting. We use cartilage as a "building block" for rhinoplasty. Most of the time we take it from the septum because it is readily accessible in the same surgical site and/or because it is deviated and affecting breathing. There is only so much septal cartilage we can use however. Taking too much septal cartilage is not a good idea because it can weaken the support of the nose. In such cases (often secondary or tertiary rhinoplasties), we go to the next best thing which is ear cartilage. We can safely remove a small to medium size of cartilage from the ear leaving no visible deformity, in order to get cartilage for nose surgery. On occasion a very large cartilage is needed and we resort to rib, but that is a rare need these days. I hope that answers your question.


Marcelo Ghersi, MD
Miami Plastic Surgeon
5.0 out of 5 stars 154 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.