Cartilage Grafting in Rhinoplasty

Cartilage Grafting in Rhinoplasty: An Option for Structural Support

Overview of Cartilage Grafting in Rhinoplasty

In some open rhinoplasty procedures, cartilage grafting may be used to provide structural support to the nose. The nasal septum is often a primary source for cartilage; however, in certain cases, such as prior trauma, severe deviations, or previous surgery, alternative sources may be considered.

If additional cartilage is needed, potential options may include harvesting cartilage from the rib, or in some cases, using irradiated cartilage from a donor (cadaveric rib graft). The selection of cartilage source is determined based on individual anatomical factors and surgical requirements.

Using Your Own Cartilage

Autologous cartilage harvest refers to cartilage that is taken during surgery from your own rib or ear and is a technique that may be used in revision rhinoplasty and some primary rhinoplasty procedures to support or modify the nasal structure.

The amount of cartilage that can be taken from the rib or ear will depend on individual anatomy and surgical requirements. However, in general, a rib graft can provide straighter and stronger cartilage than an ear graft, which is inherently curved.

During the procedure, the surgeon will make a small incision over the rib or ear and remove a section of cartilage. The incision will then be closed. The harvested cartilage is then shaped and prepared based on the structural needs of the individual’s nose.

Cartilage grafting allows surgeons to enhance structural support in rhinoplasty procedures. For example, if an individual experiences nasal airway obstruction due to a severely deviated septum, sections of cartilage from a rib graft may be used to provide additional support whilst also maintain an appropriate shape or contour of the nose. Additionally, cartilage grafts may be used to modify the nasal tip, adjust nasal projection, or provide additional support to a crooked nose.

Using Donor Rib Cartilage

Another option for cartilage grafting is an irradiated homologous rib graft, commonly referred to as donor rib allograft cartilage. This graft undergoes irradiation, which reduces the risk of microorganism transmission. Since this is not a transplant, there is no risk of immune rejection, and transplant medications are not required.

Potential considerations for donor rib cartilage include:

• Demonstrated safety in clinical studies as a cartilage grafting material
• No chest incision required, eliminating chest discomfort or scarring
• May reduce overall operative time
• Comparable structural properties to autologous cartilage, including similar risks of warping or reabsorption
• In many cases, may be eligible for private health insurance coverage

Some individuals may have personal or religious preferences regarding the use of donor grafts. Dr Honeybrook has experience using this graft and will discuss whether this option is appropriate based on individual surgical requirements. There are some instances where autologous rib cartilage may be recommended, and this will be reviewed in detail during the consultation process.