More and more, we are seeing the use of rib cartilage as a donor site for cartilage in secondary rhinoplasty and some complex primary nasal operations. The latest publication by Dr. Rollin Daniel, Dr. Anita C. Patel, and Dr. Jay Calvert shows how rib cartilage (or costal cartilage) grafts have become more common such that revisions of these previously thought 'definitive' operations are becoming more frequent.
Many patients ask, "Why use the rib cartilage? Can't you just use the ear cartilage?" This is a great question and I believe that there must be a good reason to take rib cartilage. The most common reason I have is that rib cartilage is stronger and more reliable in my hands OVER TIME. I believe that ear cartilage is good initially more many secondary nasal operations, but OVER TIME, the scar contracture ultimately wins and distorts the nose and the cartilage. I have many secondary rhinoplasty and tertiary rhinoplasty patients that come and see me in my Beverly Hills office from all over the world complaining that their nose looked good initially, but then over time, the shape changed and they feel they now need a rib cartilage graft to fix the problem.
Another point is that many patients believe that rib cartilage harvests will be more painful than the ear cartilage harvest. That may be true in some cases and not true in others. In any event, the choice for cartilage donor sites should be made based on WHAT IS NEEDED to do the secondary rhinoplasty with the best chance of success. I would not recommend selecting convenience over results.
For more information on the topic, see the website http://www.drcalvert.com or call the office at 310.777.8800 and ask to speak with one of our patient care coordinators or physician assistants.