What Is the Best Rhinoplasty Material for You?
Ear cartilage vs. Septal cartilage vs. Rib cartilage
When you decide to undergo rhinoplasty, you have a choice to choose from various materials. These include Autologous tissues which are from your own body (ear/septal/rib cartilage), foreign implants (silicone/medpor/Goretex), and donor rib cartilage (cartilage from a dead body.) Each of the materials has pros and cons, and the surgeon must choose appropriately based on the needs during the surgery. In this post, I would like to discuss few of the autologous cartilage materials the plastic surgeons use and pros & cons of each material.
The above diagram shows a clear difference of harvested amount between ear, septal, and rib cartilage.
Overall, the main differences we need to focus are the supporting strength (durability) and the harvested amount. These two factors significantly influence the usage of each cartilage.
1. Septal Cartilage
Septal cartilage is an autologous tissue located inside the nose which the amount is limited depending on the person. The condition can be varied by its ethnicity in general. While Caucasian and Middle Eastern tend to have a right amount of septal cartilage, Asian and African American tend to have a feeble and small amount.
Septal cartilage is significant in both functional and aesthetic states because the deviation in septal cartilage causes a breathing problem. Sometimes, the septal cartilage can be deviated or damaged due to accident or physical disturbance. That is why septal deviation rhinoplasty has become high in demand in plastic surgery field.
Most of the rhinoplasty specialists choose to use septal cartilage for a primary rhinoplasty because it is much easier to use than harvesting and carving a rib cartilage. They may use silicone implant along with the septal cartilage to add bridge heights if needed. Unless the patient requires a reconstructive surgery such as cleft lip rhinoplasty or a dramatic change of nose shape, the septal cartilage is appropriate for a primary rhinoplasty.
One of the most critical disadvantages of septal cartilage is the harvested amount. Once your previous doctor used your septal cartilage for the primary rhinoplasty, it is extremely difficult to re-harvest and utilize. Overall, the harvesting amount should be limited at a certain point to prevent any collapse of septal cartilage supporting the nose. Therefore, septal cartilage rhinoplasty is best for patients who never had a rhinoplasty before.
2. Ear Cartilage
Many patients say that they had ear cartilage rhinoplasty. This is true, but ear cartilage is probably not the only material that they have used. When they have had ear cartilage rhinoplasty, this could mean they used a silicone implant for bridge and ear cartilage for the tip protection. Or, it could also suggest that they used a septal cartilage for the structure, ear cartilage for the tip protection, and silicone implant for the bridge augmentation. What I am trying to explain is that ear cartilage alone cannot be the only material for your rhinoplasty.
Ear cartilage is an autologous tissue located inside the ears, and the harvested amount is minimal. Ear cartilage is very soft in texture and curvy in shape. Therefore, it is never the primary material for creating the structure in rhinoplasty. Ear cartilage cannot stand the strength of the nose which may eventually cause a collapse. The primary purpose of its use is to cover the tip of the nose for a natural appearance at the tip. It is not possible to create a beautifully crafted nose by solely using an ear cartilage.
Use of Ear Cartilage for Revision Rhinoplasty – Ear Compositive Graft
In some special cases, ear cartilage can be utilized for a reconstructive rhinoplasty. When the patient’s nose is severely damaged to the point which requires graft transplantation, ear compositive graft can be performed in addition to revision rhinoplasty. Ear compositive graft is highly advanced transplantation of ear skin, tissue, and cartilage as a whole for patients who suffer from tissue damage and contraction.
Rib cartilage consists of most supporting power (durability) and harvested amount among any other tissues. It is especially an ideal use for patients who undergo revision rhinoplasty. Nowadays, it is also commonly used for patients who desire rhinoplasty for the first time to improve their relatively weak, short, or small nose structures. Using silicone and septal cartilage is not recommended for them due to the limited amount of harvest from the body. In other hands, rib cartilage can be harvested sufficiently to build the whole structure, nose bridge, and the tip as well. This allows the surgeon to fully design the nose from the basement to the tip without using an implant.
Compared to other softer cartilages like septal cartilage, and ear cartilage, the rib cartilage gives much stronger support to the base structure of the nose. The natural rib cartilage that is harvested from your body is the best solution in terms of safety and naturality. This autologous cartilage has less risk of complications compared to other foreign implants because your body can accept your own cartilage readily. (Not donor cartilage) For patients who are looking for revision rhinoplasty due to contraction (short nose), the rib cartilage is the best choice regarding long-term. Contraction is one of the typical symptoms from rhinoplasty which causes the tissues to contract eventually giving a short nose. The rib cartilage is the best choice for surgeons to lower the nostril angle by adding the length. (See below for example.)
(The best advantage of rib cartilage is that it can add length to your nose. Ideal for revision rhinoplasty who are experiencing contraction.)
Since rib cartilage is the thickest material for autologous tissue graft rhinoplasty, it takes more time for the healing process. Most of the patients’ swelling goes down in 2 weeks, but the patient would have to wait at least 6 months to a year for the final result.
Ultimately, these are general ideas of your possible rhinoplasty materials. Indeed, it is critical to for you to communicate with the doctors, so they are fully aware of your condition, concern, and what you would like to achieve from the rhinoplasty. The appropriate rhinoplasty material depends on such factors.