In Adam Apple Augmentation Does The Grafted Cartilage Grow Into The Thyroid Cartilage?

Q: Dr. Eppley, Hope you are doing well! I was just curious, when you perform Adam’s apple augmentation, does the grafted cartilage heal and become one with the preexisting Adam’s apple? And just in case you’re able to answer this as well, is the cartilage is only grafted from the rib area? Thank you so much for all you do!

A:When performing Adam’s apple augmentation there are two techniques to do so….rib cartilage (which is the only donor source that provides enough harvest material) and an implant material. (Medpor sheet) Since you asked about rib cartilage it is important to understand how rib cartilage (as well as all cartilage grafts) heal as it is very different than bone grafting from a biologic standpoint. Cartilage is an acellullar and inert tissue. Thus when it is grafted it is largely non-dynamic…meaning it just sits there. It becomes encased in scar but does not really blend in and become part of the natural cartilage bed on which it lies. Unlike bone it does not got through a process of breakdown and incorporation. Its remains fixed onto the site in which it is implanted but never becomes truly integrated into the recipient site tissues.