Q: I want to augment my nose from the top down to the tip of my nose. I am of Asian decent. But my question is using cartilage, how can my nose be reshaped?? Since cartilage is kind of like meat can it have a form like silicone implant ? Also I heard that cartilage can shrink or warp?? THEN WHAT HAPPENS TO MY NOSE ???
A: What you are interested is a very common treatment for the Asian type nose, that of dorsal augmentation rhinoplasty. This can be done as either dorsal (alone the bridge) augmentation only or as dorso-columellar (done the bridge and then a 90 degree turn at the tip and then down underneath the columella which is the strip of skin between the nostrils) augmentation. By far, the most common method for this type of nasal augmentation is with the use of preformed silicone implants.
But the procedure can also be done using your own cartilage. This obviously requires a cartilage graft harvest, almost always from the rib. Because of the donor scar and the temporary after surgery discomfort, most patients choose an implant. (even though from a long-term standpoint your own rib cartilage is better) Your concepts about cartilage shape and how it feels, however, is not accurate. It is not like meat but more like the consistency of a carrot stick. (as a matter of fact one is trained on how to carve cartilage using a carrot stick!) The rib (carrot stick) can be carved and then placed into the nose just like an implant. One has to be careful in harvesting the graft so that as a straight a graft as possible is taken and it must also be carved straight so it does not look crooked in the nose after it is placed.
Dr. Barry Eppley