Q: Dr. Eppley, I have had five previous rhinoplasties to get my nose built up the way I want it. At the last surgery, the doctor put in a silicone implant. While that make it look better, it is still inadequate. What I want to know is whether diced cartilage can be used to make my nose bigger as it is still too small. What are the side effects of diced cartilage in the nose?
A: If I understand your question correctly, you are asking whether a diced rib cartilage graft will make for a bigger nasal dorsal augmentation that an exiting silicone implant. The answer might be yes although a more accurate answer would come from knowing exactly what type and size implant is in your nose and what you looked like before it was placed. In most cases, a rib cartilage graft offers more volume than an implant given the amount of rib cartilage that can be harvested. A diced rib cartilage graft can also be molded and shaped much better than an implant without the risks of warping or external deformity. That is the value of dicing a solid rib, it because moldable like clay material when placed in a sheath of surgical or fascia. With any rib graft, there would also be no long-term risk of infection or displacement which is always a potential issue with a synthetic implant. Also understand that the silicone implant must be removed and replaced by a cartilage graft, you can not or should not add a cartilage graft over an indwelling synthetic nasal implant.
Dr. Barry Eppley