In revision rhinoplasty using cartilage from donor sites might be necessary. Autologous cartilage (one's own cartilage) is the best material to utilize for revision rhinoplasty surgery.
Revision Rhinoplasty with Rib Cartilage
How to Take Cartilage from the Rib Cartilage?
The decision to take cartilage from the rib cage during surgery is determined after lifting the nose skin as needed. In women, the incision is aligned with the right side, to the lower curve or line under the breast. This way, the scar is concealed by the breast, remaining unnoticed even when wearing a bikini.
Access is gained through a 3-4 cm incision in the skin, reaching the rib cartilage through the subcutaneous fat and muscle layers. During accessing rib cartilage for revision rhinoplasty, I always strive to preserve these muscle layers, known as the 'muscle-sparing technique' in the literature. Using this technique, recovery and return to normal life are much faster after taking rib cartilage. Postoperative pain is also minimized.
Typically, the 6th rib is preferred when taking cartilage from the rib cage, as shown in the blue cartilage structures in the photograph. A portion of the rib cartilage is taken, and this extraction does not create any deficiency or weakness in the body. When the rib is properly repaired after extraction, there is no visible deformity or depression when viewed from the outside.
Is it Always Necessary to Take Cartilage from the Rib Cage in Revision Aesthetic Nose Surgery?
No, it is necessary only if the cartilage structures in your previous surgery have weakened significantly, and your nasal cartilage resources have been consumed extensively. In summary, it is required when the need for support has increased, and the material required for support has been consumed in previous nasal surgeries. There is always a possibility of this in every revision nose surgery, so it is essential to inform the patient undergoing surgery about it.
Does Taking Cartilage from the Rib Cage Cause Pain?
Unfortunately, some pain does occur. However, there are very strong pain relievers available to minimize this pain. Additionally, it is possible to minimize this pain to a minimum with the correct surgical technique. I have a scientific study published in 2017 in JAMA Facial Plastic Surgery on this technique. The results of our study showed a significant reduction in rest and movement-related pain in patients who underwent rib cartilage extraction using the muscle-sparing technique compared to the muscle-cutting technique. Almost no rest pain was observed after the 2nd day of surgery when the muscle-sparing technique was used.
Ear Cartilage in Revision Rhinoplasty
When is Nose Surgery Performed by Taking Cartilage from the Ear?
Surgery to take cartilage from the ear is often performed when there is a decrease in nasal cartilage reserves in patients who have previously undergone surgery. In revision nose surgeries, the need for cartilage may be directed to the ear cartilage or rib cartilage.
Is Taking Cartilage from the Ear Necessary in Every Revision Rhinoplasty?
No, it is necessary only if the cartilage structures in your previous surgery have weakened significantly, and your nasal cartilage resources have been consumed extensively. In summary, it is required when there is a need for material, and the necessary material for support has been consumed in previous nasal surgeries. There is always a possibility of this in every revision nose surgery, so it is essential to inform the patient undergoing surgery about it.
Is it Harmful to Take Cartilage from the Ear?
Taking cartilage from the concha, the part of the ear, does not cause external shape distortion. The incision is hidden within the ear. After surgery and a good recovery, when a person holds both ears together, the side where the ear cartilage is used will feel slightly softer. It does not create a functional or shape problem.
