Will The Use Of A Rib Graft For A Revisional Rhinoplasty Make My Nose Bigger?
Q: I have already had three rhinoplasties. And at the moment, I have no cartilages, just a scar tissue. If a cartilage from the rib is inserted during my fourth rhinoplasty, does it mean that the size of my nose will increase? what effects can I expect for the fourth time? Can the size of the nose get bigger?
A: While your nose may have collapsed and cartilage has been removed from the three prior rhinoplasties, I am certain you have some cartilage left in your nose. The septum and the upper cartilages undoubtably persist but the most severe cartilage loss is in the lower alar or tip cartilages. This probably causes problems not only in its appearance but also in how well you can breathe through your nose.
When significant cartilage grafts are needed and the typical places for graft harvest have been previously used or can not offer enough, a rib or costal graft is the next and last harvest area. The rib(s) has more than an ample amount of cartilage for any single nasal reconstructive procedure. How the rib graft is harvest and used, however, is based on what is needed in the nose. Typically, a solid rib graft is used to built up the nose along the dorsum or as a combined dorso-columellar strut construct. This will make the nose bigger in terms of more projection and dorsal and tip height. Rhinoplasty with the use of a rib graft always means that the structure of the nose will be more built up or moved outward from the plane of the underlying face.
Dr. Barry Eppley