Rib Graft Rhinoplasty

Q: Dr. Eppley, As you know, there area number of procedures I am looking to get done, and I wanted to get your opinion on one of them as I read some excellent articles you wrote on the use of rib cartilage as grafting material for Asian rhinoplasty.

One of the procedures I would like to have performed is revision rhinoplasty as my implant is not completely straight, and I do not think the shape is successful. I believe it’s difficult for surgeons to really shape rib cartilage, and wanted your thoughts / opinion on shaping it for a very feminine look: a good height, generally slim bridge and width, with a curved line all the way to the tip. How can this best be done and what is your experience?

A: You are correct in rib graft rhinoplasty that shaping rib cartilage can be difficult and there is always the risk of it warping after surgery. If the rib graft can be ideally shaped as a solid piece to achieve your goals then that would be a good method to do it. But between the shape of the harvested rib and the unpredictability of whether it will warp its fashioned shape, this has led to the use of a diced cartilage graft approach. This allows it to be molded into its desired shape. This is the preferred approach in many cases of rib graft rhinoplasty today.

Dr. Barry Eppley

Indianapolis, Indiana