Can An Ear Cartilage Graft Be Replaced With A Rib Graft In A Revisional Rhinoplasty?

Q: Dr. Eppley, I recently had augmentation rhinoplasty to build up  my bridge a and bilateral spreader graft to widen my nose. I am not sure the use of ear cartilage was appropriate for my wants. I wanted my radix to tip slightly augmented and my Dr. used ear cartilage. I never had an over done rhino before either it was a just tip work on my first. I just decided I wanted a more masculine nose. I am looking for some answers about a possible third rhinoplasty yikes. I have never had cartilage taken out of my nose. I am 25 year old caucasian male. I am looking for a surgeon who works well with rib grafts.

A: My assumption  is that based on your description that the ear cartilage graft was used to build up the radix. But that has left you with more of a ‘scooped out ’ dorsum with too high of a radix and the rest of the dorsum too low or that the entire dorsum is now too high and more of a hump? When trying to build up the entire dorsum, I find it difficult to do that with a curved piece of cartilage that simply doesn’t have adequate shape for the complete dorsal line. But it is often used when a septal graft is not available and the concept of a rib graft seems too extreme. In a subsequent revisional rhinoplasty, the ear cartilage graft can be removed and replaced with a rib cartilage graft which offers a straighter piece that can be more assuredly shaped to the desired result.

Dr. Barry Eppley

Indianapolis, Indiana