When is It Best to Use Your Own Cartilage for Rhinoplasty?

It is always better to use your own cartilage if possible because it provides a lower risk of infection and complication, higher rate of incorporation, and better adaptability. In revision cases, it is even more imperative as the blood supply may be compromised from the previous operation(s), and, as a result, synthetic material may have a higher potential for failure. In primary cases for Asian, Hispanic, and African-American patients, silicone may be acceptable for dorsum; however, I still prefer patient's own cartilage.

It is best to use one's own cartilage for grafting in rhinoplasty surgery. Depending on the purpose of the graft, septal cartilage and ear cartilage are often successfully utilized. If these sources are unavailable or insufficient  quantities available, then other options such as rib cartilage or synthetic material may be considered. The necessity of grafting during rhinoplasty and source of grafting material should be discussed at the time of consultation, after a nasal examination.

Sincerely,

Tom Kaniff

I prefer to use your own cartilage in all primary and revision rhinoplasty cases.  I have found that there is very little failure of cartilage when the cartilage you are using is your own,   If you are using cadaveric cartilage, although the literature states that there is very little absorption and failure of cadaveric cartilage in rhinoplasty, I am not certain that this is in fact the case.  I use cartilage from your septum, ear, and even rib cartilage depending upon the severity of the defect I am repairing, and the availability of these cartilages in revision cases.  I rarely use synthetic material for grafting due to the higher incidence of infection especially in complex revision cases.  Dermal fillers are a good alternative for minor defects in the nose if revision surgery is not an option for you.

There is no absolute better or worse, just advantages and disadvantages to alloplast (implant) vs. autogenous tissue.  Primarily, implants are quicker and easier to use, and do not require your surgeon to harvest donor cartilage from your nasal septum, ear, or rib.  Implants however, may become exposed or infected over time, and require removal.  Proper placement of the implant diminishes the possibility of exposure or infection.  The use of RNA inhibiting peptide or a similarly functioning analog, I believe, will significantly diminish or eliminate implant related infection in the future (Balaban et al, Tufts University).

Cartilage from you is the best almost always since we rarely get an infection. In 35years I have never had an infection. Done by an experienced rhinoplasty surgeon you should not have a problem.

If the nasal bridge needs to be raised, and Rhinoplasty Surgery is necessary for tip refinenent, I typically prefer a synthetic ePTFE implant over cartilage. ePTFE implants may be custom carved in the OR, and my experience with this material has been favorable. Complications with ePTFE like infection, extrusion, or misplacement are uncommon and occur in less than 5% of patients. The majority of my patients withh ePTFE dorsal nasal implants are thrilled with their results.

Many reputable rhinoplasty surgeons prefer septal cartilage, ear cartilage or rib cartilage for dorsal augmentation. There are pros and cons with nearly every procedure, so you should discuss all of your options with your surgeon to see what might be best for you.

Dr. Joseph

It is always best to use one's own cartilages from the septum or ear. When not available then synthetic materials can be considered but again it should be a rare situation.

You have asked the very question that is so often discussed at plastic surgery meetings. The answer varries from doctor ot doctor and year to year. My feeling is to use autografts if possible but, you may not have enough septal cartilage to do this. If that is the case alloplasts are also a good choice

The ideal implant is always to use your own tissue.  However, this is not always possible and not always desired by the patient based upon how the cartilage is harvested( i.e. rib)

Whenever possible (if available) using your OWN tissue as grafts is ALWAYS better than tissue from another human (radiated etc) or man made (Synthetic). Your own tissue is better accepted, lasts longer, has a lower rate of scarring, infection, rejection or ulceration. Son, if there is good cartilage that could be harvested elsewhere I would seriously recommend that before considering another graft source.

Peter A Aldea, MD