Diced Cartilage Grafts in Rhinoplasty
Q: Dr. Eppley, I had recently posted a question on Real Self regarding diced cartilage grafts and that there is growing evidence that source of the cartilage has an influence on the longevity of the graft. You had kindly answered my question stating that it makes a difference where it comes from (below link).
Could you be so kind as to advise which one would hold better in the long run if I am faced between using either ear or rib for DCF? I understand that ear curls, deforms or may shrink on the bridge but I also fear that rib graft will ossify over time. Which graft would give me a better chance of it being permanent.
A: When you dice a cartilage graft tin rhinoplasty the issue of shape maintenance is irrelevant regardless of the donor source…as that is the primary reason it is diced. It is done to both achieve the desired shape and prevent any long-term shape deformation. Whether the donor source has a major difference in longevity can be debated but what is most important is the volume of graft needed. For small nasal augmentation diced ear grafts may be fine but most nasal augmentations in Asian patients require more volume than even two ears can provide.
Dr. Barry Eppley