Tuesday, June 28, 2016

Rib cartilage for revision rhinoplasty

Rib cartilage for revision rhinoplasty is a frequently used alternative if septal cartilage is not available and significant amounts of grafts are necessary for the revision. Rib cartilage is especially helpful when there is a saddle nose deformity after rhinoplasty.

There are two option with rib cartilage for revision rhinoplasty. Using your own rib is an excellent option but requires another operating site with 3-4 inch scar under the breast line. The one rare risk associated with utilizing your own cartilage is a pneumothorax or collapse of the lung. With meticulous surgery and in the hands of an experienced revision rhinoplasty surgeon who uses autologous rib cartilage this risk is quite low.

The other option is cadaveric irradiated rib cartilage. This cartilage is taken from screened donors, purified, sterilized, and then irradiated to assure it is acellular and can be used for grafting. With this option, there is no second site surgery and therefore none of the risks associated with it. The rate of infection and warping have been reported to be the same as autologous rib cartilage. One study has reported that the rate of resorption with cadaveric rib cartilage is slightly higher than autologous cartilage with revision rhinoplasty.

Irradiated cadaveric rib cartilage is safe and a viable option in revision rhinoplasty. However, some patients prefer using their own rib cartilage for the procedure.

Dr. Funk is a revision rhinoplasty surgeon in Houston.