A rhinoplasty surgery is not just about improving the outside appearance of the nose. An equally important motive is to preserve its structural integrity, which could be done with cartilage grafting, so the results can last a lifetime.
Cartilage is a flexible connective tissue that is found in the lower half of the nose. In rhinoplasty, it is harvested from areas of the body where it is plentiful (e.g., bowl of the ear, septum or wall between the nostrils, and rib) and then sculpted into a specific shape to achieve the patient’s cosmetic goals and to create a strong underlying structure as well.
Rhinoplasty Los Angeles expert Dr. Tarick Smaili says the septal cartilage is the most preferred source because its quality is almost the same as the rest of the nasal cartilage. For this reason, it provides the most predictable results among other sources.
Another advantage of using one’s septal cartilage, he adds, is that no additional incision is used to collect it. Other sources, meanwhile, will require another cut just to retrieve them, although a good surgeon will make every effort to hide the scars.
For instance, using ear as the cartilage source requires a discreet incision behind it, without affecting its outside appearance and function.
If there is not enough septal cartilage inside the nose, which might be the case in revision rhinoplasty and patients requiring large augmentation, the ear cartilage is believed to be a good alternative.
Nevertheless, ear cartilage poses several challenges due to its curved shaped, limited amount, and less structural support compared with septal cartilage. As a result, using this material requires more technical skills to achieve impressive results, explains Dr. Smaili.
Another possible source is the rib, although many surgeons consider it as their last resort. While it is notable for its strength and abundance, compared with other sources it has a higher risk of resorption (dissolving), shifting, warping, and visibility under the skin.
But no matter where the cartilage grafts have been sourced, in the hands of a board-certified plastic surgeon who performs primary and secondary rhinoplasties on a regular basis impressive results can be still achieved, with very minimal risk.
In some cases, artificial implants might be a better option than the patient’s own tissue. However, this is only true for individuals whose cartilage quality or quantity is low, or they require larger augmentation just like in many cases of Asian rhinoplasty.