As I plan my lectures for two upcoming meeting, I am realizing how many secondary rhinoplasty operations require rib cartilage to make the result work. In the past, I would have said that ear cartilage could be used for many secondary rhinoplasties. Now, I am not so sure. I use composite ear cartilage grafts quite frequently when lengthening the short nose or treating alar retraction. However, I use the rib cartilage for the extended spreader grafts and lateral crural strut grafts. The reason for this is to maintain shape and strength over time.
Examples of Rib Cartilage Grafts with composites
secondary rhinoplasty with rib cartilage graft
So do not be put off if your surgeon is adamant about using rib cartilage to make your new nose! It is probably in your best interest and the results will last over time
Harvesting Rib Cartilage
One of the huge worries about harvesting rib cartilage is the scar. The other is the pain. I can tell you that with my muscle sparing rib cartilage harness, the pain is much less then if the muscle gets cut. As I dissect down to the external oblique muscle and the junction with the rectus abdominis muscle, I part the external oblique without cutting the fibers. This allows for early healing. Do not get me wrong, all the patient say this hurts. However, secondary rhinoplasty with rib cartilage graft is not for easy to solve problems. If you are in need of this type of operation, then you will need to recognize what it will take to improve.
Please feel free to contact the office at 310.777.8800 or at firstname.lastname@example.org so that can have your questions answered. Dr. Jay Calvert has offices in Newport Beach and Beverly Hills, CA where he sees patients and operates locally.
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