Best cartilage for bridge
Based on your description it appears that you ma need revision rhinoplasty with rib cartilage, such as the example in the link below. It is possible that there may be enough cartilage in the septum of your nose to do the job but not likely.
Best Cartilage to Augment Nasal Bridge
Best Cartilage to Augment Nasal Bridge I prefer to use diced cartilage/temporalis fascia grafts to augment the over-resected nasal bridge. In order of preference I use septal, ear, or rarely rib cartilage.
Dorsal on lay material to augment the bridge during correction rhinoplasty.
Septal cartilage is a good material for dorsal on lay because of its rigidity. After this I prefer very thin Medpore sheeting. There are plenty of other options however.
Best cartilage for refinement and bridge definition
Although it may be easier to assess your photos or nose in person, I believe that it sounds like you may need a moderate amount of volume. Due to your previous surgery, it may be that your septal cartilage was harvest, or is simply not adequate for what you require. You will likely require harvested rib cartilage to create dorsal height and further tip definition/support.
Cartilage grafting for secondary rhinoplasty
Thank you for your question. There are multiple factors that need to be considered in determining the best source for cartilage grafting in secondary rhinoplasty. Nasal septal cartilage is usually the preferred source for grafting, but is often insufficient in secondary rhinoplasty. Other options include ear cartilage and rib cartilage. I would recommend a consultation with a board certified Facial Plastic Surgeon with extensive experience in revision rhinoplasty. They can assess the amount of augmentation needed and advise, based on their experience, the best treatment options for addressing your concerns. Best of luck to you.
Graft volume, contour, and donor site morbidity will determine the "best" donor cartilage
In choosing a cartilage donor site, it is important to know the volume of graft necessary, contour characteristic of the donor graft, and the morbidity at the site of graft harvest. With severe collapse, rib cartilage may be the only donor site that may yield sufficient volume, but has the disadvantage of a painful donor site with scarring on the chest. Furthermore, it can be calcified and difficult to use in older individuals. Septal cartilage from the nose is available in limited quantities and is usually straight, pliable and easy to use with no donor site morbidity. However, limited availability confines its utility to small dorsal defects. Ear cartilage has the added problem of natural curves. These curves work well at the tip of the nose but is disadvantageous when seeking to rebuild a straight nasal dorsum. Furthermore, minor irregularities at the donor ear can occur.
#Rhinoplasty graft sources #plasticsurgery
This answer depends on the amount of cartilage needed for dorsal nasal reconstruction. Septal cartilage is an option for some patients with minor contour issues and enough septal cartilage remaining after primary rhinoplasty. Costal or 'rib' cartilage is a source of large pieces of cartilage that can be used to restore substantial structural and cosmetic deficits in secondary rhinoplasty surgery.
The best source of cartilage is the one that your surgeon is most comfortable with. In otherwords, some surgeons are accustomed to using cartilage from the rib while others from the ear. Both cartilages can do the job well, but the results are more dependent on the training and skill of your surgeon. Do your research. Ensure appropriate board certification and experience in rhinoplasty surgery. Look at before and after photos, and make an informed decision based on results. Best Regards.
Best cartilage to use for refinement of the bridge
Revision rhinoplasty is more difficult than a primary rhinoplasty, so it's important to choose your specialist very wisely based on extensive experience. Nasal cartilage is always the primary source for grafting purposes when performing a rhinoplasty procedure. It's important to note if there is any cartilage left on the inside your nose from the prior rhinoplasty procedure. If there is a cartilage depleted nose, ear cartilage is the next best source, then rib
Hello and thank you for your question. In order to answer this question, photographs would be very helpful. Usually septal, ear, or rib cartilage are all options. 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.
Harvard-trained plastic surgeon