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The Pros and Cons of Rib Cartilage Rhinoplasty

by | Feb 13, 2015 | Blog, Rhinoplasty

My schedule at About Face in Bondi Junction is almost always filled with a variety of rhinoplasty surgeries. Some are medical necessities; others are purely cosmetic. In both cases, I often have to use cartilage from another part of the patient’s body to create a beautiful proportionate nose.

As part of the procedure, a nasal graft is almost always needed to maintain stability and create a balanced, natural looking appearance. I find artificial materials to be impermanent and unreliable, so whenever possible, I like to use only my patient’s own cartilage or bone to make the grafts.

The benefits of using rib cartilage are tremendous. When used properly, rib cartilage provides superb building material right from a patient’s own body. I don’t need to implant synthetic materials to achieve a pleasingly aesthetic, long-lasting result.

Let me tell you more…

Three Types of Cartilage Used in Rhinoplasty

The wonderful thing about using my patient’s own cartilage for rhinoplasty is that the results will last forever. The same cannot be said of an artificial implant which may look good initially, but which can become problematic over the long term. Cartilage to rebuild the nose may be harvested from three areas of the body:

  • Nose Cartilage for Rhinoplasty – Septal cartilage is straight, firm cartilage that does not require harvesting from outside the nose. It is the preferred cartilage, but there may not be a sufficient amount to work with.This is especially true in revision rhinoplasty where a patient may have already had septal cartilage removed.
  • EarCartilage for Rhinoplasty – Ear cartilage can be used in certain small grafts, but it tends to be weaker than nasal cartilage and is not always strong enough to support a nose that require major reconstruction
  • Rib Cartilage for Rhinoplasty – Rib cartilage is extremely resilient. Like nasal cartilage, it’s strong enough to withstand the constant expansion and deflation that occurs when we breathe.

Dr George Marcells Explains Rib Cartilage for Rhinoplasty

One reason I particularly like to use rib cartilage for nasal surgery is it’s proven record of safety:

“The overall long-term complications associated with autologous (from the patient’s own body) rib cartilage use in rhinoplasty were low.” – Study conducted at the National Medical Center, Seoul

It is also a relatively simple procedure. The rib cartilage is harvested through an inconspicuous 2-3 cm incision on the chest. On women, it can be tucked under the right breast.

There is some discomfort for 48–72 hours, but it is an ambulatory procedure and my patient’s can comfortably go home the same day. Some patients might choose to have one overnight stay.

Risks Associated with Rib Graft Rhinoplasty

There are some risks associated with using rib cartilage for a rhinoplasty. The most common are:

  • The grafts become visible under the skin
  • The grafts shift
  • The grafts dissolve
  • The grafts are reabsorbed

Rarely, the incision can cause damage to the underlying lung or tissue layer around the lung. As a result, air is introduced around the lung. This extremely unusual complication (pneumothorax) can be managed by temporary placement of a chest tube for a few days following the procedure.

Why Don’t More Surgeons Perform Rib Cartilage Rhinoplasty?

Many of the rhinoplasty procedures I perform at About Face are with rib grafts. We’re one of a limited number of practices in Australia that use this technique. Considering its benefits, you may wonder why more surgeons don’t perform rhinoplasty using a rib graft. It’s because rib cartilage can have a tendency to warp or change shape.

During the course of my career, I’ve become an expert in the use of rib cartilage in rhinoplasty. I’m familiar with the proper locations within the nose and proper surgical techniques that allow me to greatly reduce the possibility that any changes within the shape of the rib cartilage will affect the outward appearance of the nose.

If you have questions about nasal surgery, nasal grafts, revision rhinoplasty, or anything to do with a beautiful, functional nose, I hope you’ll contact us at About Face in Bondi Junction.

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Meet Dr Marcells

MBBS (Syd), FRACS (ORL-HNS)
President – Australasian Academy of Facial Plastic Surgeons

Dr George Marcells is known for excellence in facial plastic surgery and is considered a true master of rhinoplasty. He performs advanced surgical techniques to restore balance and harmony to the face and can also resolve functional issues such as breathing difficulties.

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