What are the benefits/disadvantages of using ear cartilage or rib cartilage in revision rhinoplasty?

Ear cartilage is easier to harvest with a scar that is hidden completely but ear cartilage is too soft to provide structural support.  Rib cartilage is more useful, but often septal cartilage can be used even in patients who have had a septoplasty.  I feel that the goal of optimizing the nose justifies rib cartilage if it is the better choice to reach the desired goal. The incision for rib harvest is short and if the overlying muscle is split rather than cut to reach the rib the recovery is not difficult 

Cartilage is a key component of structural rhinoplasty. The best option for cartilage is usually the nasal septal cartilage. If this is not available, then rib or ear cartilage can be used. Ear cartilage is easy to harvest, but does not provide as much cartilage as rib cartilage and ear cartilage is also not as strong as rib cartilage. Rib cartilage is also nice, because the lining of the cartilage, the perichondrium can also be used as a graft in material.

In our practice, we will use use nasal cartilage first as the primary grafting source for a revision rhinoplasty procedure.  If there is a cartilage completed nose from prior surgery, then consider ear cartilage.  Rib cartilages is rarely ever required and has a its own set of issues.

I prefer ear cartilage, rarely using rib cartilage in revision rhinoplasty unless a large amount is needed. I want to avoid placing a scar on the chest, it is a more difficult and painful procedure for the patient, and there are increased risks.