Which Is A Better Rib Graft For Rhinoplasty – Diced Or Solid Graft?

Q: Dr. Eppley, I have questions about using rib grafts for rhinoplasty. How would the surgeon even determine if the rib graft he is going to take would be straight ‘enough’ for it to be placed directly to augment the bridge? What if the carving of the graft isn’t successful? Would you diced it instead and continue the surgery when the patient requested not to have the diced method done? After reading what you have written, a diced cartilage method is obviously better than a ‘single rib’ method right? But one question is that why many patients and surgeons are choosing the ‘single rib’ method instead of the diced method? Can I also know how much does a rib graft rhinoplasty cost? Does it include tiplasty and alarplasty too? Thanks Dr!

A: The quality and straightness of the rib graft is determined by the skill and experience of the surgeon taking it. There are a  lot of rib choices on the lower end of the costal margin from the free floating #9 to the fixed ribs #s 6, 7 and 8. Usually a straight piece can be obtained as the longest rib graft that is needed does not usually exceed 4 cms. 

If the patient does not want a diced graft method and does not consent to that option, then only the single piece method would be used.

The question of whether a diced vs a solid rib graft is better is a controversial one and every surgeon will have their own opinion on that matter. The answer would also depend on what the nose anatomy is and what one is trying to achieve. It is never that one method is always better than the other, it must be taken on an individual case basis. 

A rib graft rhinoplasty can or cannot include tip and other work depending upon what needs to be done. I would view it as a comprehensive rhinoplasty with one fixed cost, no matter what needs to be done.

 As a ball park figure, all costs included, the cost is in the range of $8,500 to $9,500.

Dr. Barry Eppley

Indianapolis, Indiana