MarinAesthetics

Revision Rhinoplasty Using Rib Cartilage


Rhinoplasty or a nose job is one of the most technically challenging operations performed by plastic surgeons not just in San Diego, but the entire country as well. As a result, many doctors are not trained to a sufficient degree on the intricacies of the operation. This can leave their patients with a less than satisfactory result, thus, needing a revision rhinoplasty.

Since this is the second, third or even fourth operation in some patients, there can be considerable scar tissue and damaged cartilage or bone from the previous operations. Although not always the case, frequently, additional cartilage will be needed and your surgeon will have to “borrow” this from your ear or rib. This allows your doctor to rebuild the collapsed areas or fractured cartilage with fresh tissue able to maintain its shape long term.

  

This does require a second incision to harvest the cartilage, which is then carved into the proper shape to help rebuild specific areas of the nose. Not many surgeons have experience with this technique or procedure, and frequently don’t offer it to their patients. Dr. Marin has extensive experience with this procedure and has authored text book chapters on the subject.

If you are in need of a revision of your previous rhinoplasty or nose job procedure, contact our San Diego Plastic Surgery office at 858-638-9800 or online at MarinAesthetics.com/contact to schedule an in-person consultation with Dr. Marin. He can evaluate your situation and perform computer imaging to help you understand what is possible in revising your original operation.

Reasons for Revision Rhinoplasty

The main reasons for revision rhinoplasty include dissatisfaction with the results of the first surgery, improper healing of the nose after the first surgery, or the removal of excess scar tissue. For revision rhinoplasty patients, there are a number of ways to reconstruct the nasal framework. These methods include harvesting cartilage from the ear, septum, or even the ribs. Most often cartilage will be harvested from the septum first, the ear second, and the ribs last. While grafting cartilage from the ribs is often the last option, it is an equally viable option. Here are some important things to know about harvesting cartilage from the ribs in order to perform a revision rhinoplasty.

Why Use Rib Cartilage

Dr. Vincent Marin usually prefers to harvest cartilage from the septum during a revision surgery, but sometimes this is not possible, as the cartilage from the septum may have been used in the previous rhinoplasty procedure. In this instance, Dr. Marin will use rib cartilage to add support to the nose. Rib cartilage is sturdy and often the perfect match for the cartilage in the nose. The rib cartilage can even be used to support the nasal tip, one of the most important features in a nasal revision surgery.

Where Rib Cartilage Comes From

There are a couple different options to choose from when it comes to grafting rib cartilage. It is possible to use the patient’s own rib cartilage, but this can often leave an undesirable scar. It also can be somewhat painful to the patient after the surgery. It is also possible to use rib cartilage from a cartilage bank. To accomplish this, surgeons will use grafts of cartilage that was salvaged from healthy donors. Many wonder if it is safe to use grafted cartilage. Before the cartilage is even accepted into the donor bank, it is screened thoroughly for any type of systemic disease, excess radiation, or any other issues that may be problematic. Since the cartilage undergoes such a rigorous screening process, it is safe to use for rhinoplasty revision surgery.

Risks

In general, using rib cartilage for rhinoplasty revision surgery is considered safe. As with any procedure, however, there are potential risks. Most of these risks involve risks associated with grafting cartilage from the patient’s own body. Rib cartilage is usually harvested by making a 2 to 3-cm incision, which can be made under the breast. In very rare occasions, this incision can cause damage to the underlying lung tissue. However, this is extremely uncommon and can easily be managed following the procedure. Some of the complications that are associated with grafting cartilage from the patient’s own body include cosmetic issues, such as the visibility of the grafts under the skin or shifting of the grafts.

To schedule a rhinoplasty revision surgery, contact the staff at Dr. Marin’s San Diego office. They will be happy to schedule a consultation at your earliest convenience.

About the Author:

Dr. Vince Marin is a San Diego board-certified plastic surgeon specializes in cosmetic surgery of the face, nose, breast and body. If you wish to contact Dr. Marin, write to [email protected] or you can follow him on Twitter!