Should I use cadaver rib for revision rhinoplasty?

Revision rhinoplasty is a complex surgery that frequently requires additional cartilage for grafting purposes. If septal cartilage has already been utilized from the original rhinoplasty surgery to correct a deviated septum there may be insufficient cartilage for grafts during revision rhinoplasty.

Other options for additional cartilage are ear and rib cartilage. Ear cartilage is a weaker cartilage that is thin and curved. It makes for excellent grafts to shape around the nostrils and tip of the nose. However, it is not ideal for spreader grafts or for dorsal onlay grafts that need to be more stiff, thicker, and straighter.

Rib cartilage is an ideal cartilage to build the bridge of the nose, straighten the nose with spreader grafts, or reconstruct the septum. Autologous rib or your own rib can be used in men under 45 and women under 50 as it has typically not calcified at this stage. It does require an extra incision just under the breast about 2-3 inches long.

The other option for rib is cadaver, irradiated, and purified rib. This is provided from organ tissue labs and is taken from young cadaver donor rib. Obviously the donor has been extensively screened and the rib has been purified and irradiated. Cadaver rib for revision rhinoplasty has the same warping and infection rate as autologous rib. However, some studies have shown that it may have about 20% higher resorption or absorption rate.

If you are opposed to a second site surgery and want to the avoid the risks involved with using your own rib, cadaver rib is an excellent option for revision rhinoplasty.

Dr. Funk is a revision rhinoplasty expert in Houston.

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