Q: I am in need of revisional tip rhinoplasty. But I have been warned strongly about the risks of ear cartilage, since my septal cartilage is quite probably inadequate to serve as a graft source. It would be more than a pity to spoil the present symmetry of my nose tip in the pursuit of a small derotation/lengthening. I was wondering about the possibility of newer advancements with stem cells in plastic surgery. They have received great publicity and already articles are being written on the new potential they offer and the speeding-up of changes for reconstructive medicine. I would be extremely grateful and certainly willing to undergo the surgery at any expense if you would be in a position to predict near-future applications, and incorporate them in your practice at least for volunteers to whom this would mean so much. Lots of grateful thanks, and I hope to hear from you again with some promising news or estimations, or even information some time later.
A: Stem cells in plastic surgery to make new tissues remains a hopeful but unproven surgical technique. Its appeal is great and that makes great print and internet copy but there remains a far leap from the laboratory to that of useful clinical applications. I do not know why anyone would tell you that there is ‘danger’ with ear cartilage in revisional rhinoplasty It is a very reliable, simple, and predictable graft material to use in the nasal tip and has a very long history of successful use in revisional rhinoplasty. Even if stem cells could make cartilage (and someday they will in the near future), they could not make a graft that would be better than actual ear cartilage. .
Dr. Barry Eppley