Cartilage grafts are often used during rhinoplasty to strengthen the nose, rebuild its structures, and help to improve its functions. Cartilage nose grafts can be harvested from the septum, ears, and ribs, and then placed in different areas of the nose. This is usually necessary during open nose job surgery, revision rhinoplasty, post-traumatic nose jobs, and ethnic rhinoplasty.
Patients with a pinched nose tip, a thin nose, a crooked nose, alar notching, saddle nose deformity, Polly beak deformity, nasal asymmetry, and breathing problems will probably need cartilage grafts for their rhinoplasty.
Dr Jeremy Hunt performs different nasal reconstruction techniques – with and without cartilage grafting. Over the years, he has fixed many nose concerns using different types of nasal cartilage grafts.
What Is Cartilage Grafting In Rhinoplasty?
The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Cartilage grafting is a rhinoplasty that uses cartilage grafts to reshape the nose, support its structure, and improve its functions.
Cartilage is a flexible yet firm type of connective tissue that makes up a large portion of your nasal structure. It gives your nose tip, alae, nostrils, and nose bridge their support and structure. It’s the “squishy” part of your nose. You can feel your nose tip to know what cartilage feels like.
Because cartilage doesn’t have a blood supply, it has limited ability to regrow or replace itself. Therefore, grafts can be used during a rhinoplasty to replace missing or damaged cartilage.
Usually, the grafts used during nose surgery are autologous cartilage– the cartilage is removed from a donor site and then placed in the nose of the same patient. Rhinoplasty cartilage can be harvested from the earlobes, ribs, or other parts of the nose.
Cartilage is an ideal grafting material since:
- It’s easy to sculpt
- It’s resistant to trauma
- It’s mechanically stable
- It has very low infection rates
By surgically inserting a cartilage graft into the nose, Dr Hunt can build up your nasal soft tissue and refine the architecture of your nose during your rhinoplasty.
What Are the Sources Of Nose Grafts?
Cartilage grafts can be harvested from different sites of the patient’s own body, including the septum, ears, and ribs, and used for nasal reconstruction.
1. Nasal Septum
Most plastic surgeons prefer using cartilage harvested from the nasal septum during a cartilage graft rhinoplasty. Septal cartilage is an excellent nose graft source because:
- It’s very similar to the rest of the cartilage in your nose
- It can be easily collected using the same incision done for the nose job
- It can be easily reshaped to rebuild various nasal structures
However, patients have only a limited amount of cartilage that can be harvested from their septum. Therefore, the nose may not have enough cartilage in the septum available for grafting especially during a second rhinoplasty.
In such cases, Dr Hunt might use cartilage collected from your ear or ribs.
Cartilage grafts harvested from the ear are also known as auricular cartilage or conchal cartilage.
Ear cartilage grafts:
- Can be easily removed without leaving any visible scars or causing noticeable changes in the shape of the ear
- Are flexible and easy to shape
- Can be used to reconstruct different components of the nose
Nevertheless, like the septum, the ear also has limited amounts of cartilage that can be harvested for grafting.
During rib cartilage rhinoplasty, costal cartilage is harvested from the sixth or seventh rib to fully alter the nose.
Costal cartilage is strong and available in large quantities, but it’s used as a last resort source of nose grafts because:
- It’s often associated with warping (it may become bent or twisted out of shape).
- Surgeons need to make an extra visible incision in the chest to harvest it.
- It involves postoperative pain in the chest.
Guide to Rhinoplasty
When Is Nose Cartilage Grafting Necessary?
Cartilage grafts are often needed during rhinoplasty to help reconstruct different parts of the nose.
Adding cartilage to the nose, instead of removing it, can improve the structure and/or function of your nose during different types of rhinoplasty.
Augmentation rhinoplasty is a technique that aims to make your nose look bigger or increase its projection.
The cartilage graft is sculpted and inserted strategically into different parts of the nose to augment its size and make it more prominent.
Nose augmentation surgery is usually done through an open incision technique. This incision allows Dr Hunt to gain access to the deeper tissue of the nose and better visualise your nasal structures. Nonetheless, opening the nose can make your nose tip and nostrils lose their support.
That’s why grafting during open incision nose jobs has the extra benefit of supporting internal nose structures and preventing them from collapsing.
Second nose job
The use of nose grafts is very common during revision rhinoplasty. Patients who are not satisfied with the results of their first rhinoplasty may ask for another rhinoplasty, hoping it would give them the facial balance they’re looking for.
A botched nose job can compromise and weaken your nasal structures. Dr Hunt uses nasal cartilage grafts to rebuild the bridge of your nose (dorsum) and your nasal tip and alter your nostrils after a failed first rhinoplasty.
- Tip revision surgery: cartilage nose grafts are used in tip plasty during a secondary rhinoplasty if the nose tip lacks support or projection. Nasal tip grafts can address the nose tip definition and alter its projection. Cartilage can be used to add support to the structure of the nose, especially for patients with weak, drooping cartilage at the tip of the nose
- Revision septoplasty: during a second septoplasty, a cartilage graft can be used to reconstruct the nasal septum and correct any obstruction of the nasal passage. Different types of nose grafts can be used to fix a deviated septum and straighten a crooked nose
- Dorsum revision: a second surgery to reshape the dorsum may be needed if too much bone and/or cartilage was removed during the first nose surgery. Grafting cartilage onto the nose bridge can compensate for the excessively removed nose tissue. Nose cartilage grafts can make your nose look bigger, especially after dorsal hump removal, by adding height to your dorsum. The use of cartilage grafts is common in nose augmentation and reconstruction surgery
Post-trauma nose job
Post-traumatic rhinoplasty is done to surgically repair nose injuries. It aims to alter the appearance of the nose and resolve any functional problems such as airway blockage after a trauma to the nose.
A blow or bump to the nose can displace or damage the nasal bones and/or cartilage. Moreover, if the nose cartilage is deprived of its blood supply for too long, patches of cartilage can die leading to a nose deformity.
Hence, cartilage grafts are often used during a post-traumatic nose job to restore the shape and symmetry of the nose and fix breathing problems or other functional problems in the nose.
An ethnic nose job is done to address specific cosmetic concerns in ethnic noses. Noses such as Asian or African American noses have anatomical characteristics different than noses of other ethnicities, such as:
- Low dorsum height
- A short columella
- A broad and not well-defined nose tip
- Wide and flaring nostrils
Asian noses usually also have weak and thin alar cartilage and a limited amount of septal cartilage. Cartilage grafts can be used in the nose to compensate for the lack of cartilage in noses of specific ethnicities and to augment or lengthen the nose.
Nose Deformities Fixed with Cartilage Grafts
Dr Jeremy Hunt performs cosmetic and reconstructive nose surgeries. He often uses cartilage grafts to alter the cosmetic and functional outcomes of your nose job and fix the following concerns:
A pinched nose
When the nose tip and nostrils are very narrow, they can obstruct breathing and give the nose a pinched look. A pinched nose tip can be either congenital (you’re born with it) or the result of excessive cartilage removal during nose surgery.
Dr Hunt sculpts harvested cartilage and then strategically implants it near the nose tip to widen the nasal tip and nostrils and correct a pinched nasal tip appearance.
Alar notching or retraction
The ala is the semi-circular piece of cartilage on the outer sides of the nostril. Alar notching or contraction occurs when the alar cartilage contracts upwards making the nostrils too visible and breathing more difficult.
Nose cartilage grafts can provide support to the nostrils and correct alar retraction or notching.
Sometimes during reduction or ethnic rhinoplasty, cartilage is removed from the nostrils to reduce nostrils flaring and narrow the nose.
However, if too much cartilage is cut out during the nose job, the alae surrounding the nostril may become weak and collapse.
Dr Hunt uses reshaped nasal grafts to add support to the alae surrounding the nostrils and prevent or fix the alar collapse.
Saddle nose deformity
During a rhinoplasty, the nasal bridge (dorsum) may be excessively reduced which can result in what is known as a “saddle nose deformity”.
This type of nose deformity is commonly noticed after a failed nose job and in Asian noses.
Cartilage can be removed from the septum, ear, and even ribs, then sculpted to add height to the dorsum and improve the projection of the nose.
Polly beak deformity
A Polly beak deformity is one of the most common reasons for revision rhinoplasty. It occurs when the area of the dorsum that’s right before the nose tip has excess tissue.
This can happen when the nasal tip droops because of weak cartilage support.
Dr Hunt uses special grafts to add support to the nasal tip cartilage, raise the angle of the nose tip, and fix a Polly beak deformity.
A thin nose
A nose that is too thin will have narrow nasal valves that can limit the airflow into the nose and cause breathing trouble.
Nose grafts may be used to widen the nasal passage and fix or prevent nasal valve collapse.
A crooked nose
Some people are born with a crooked nose. On the other hand, a nose might become uneven after a previous surgery.
A deviated septum, which is part bone part cartilage, is usually the cause of a crooked nose appearance.
Dr Hunt uses a specific type of nose grafts, known as spreader grafts, to correct a deviated septum and fix an uneven nose.
If one side of the nose has less or weaker cartilage than the other side, the nose can look out of balance and appear asymmetric.
Nose cartilage grafts can improve the balance between the two sides of the nose and restore nasal symmetry.
Using cartilage grafts during nasal reshaping procedures can also improve breathing and remove the nasal obstruction by:
- Widening the nasal passage
- Correcting a deviated septum
- Reopening a narrowed nasal airway
- Widening the nostrils
- Fixing nasal valve collapse
Cartilage Grafts vs. Silicone Implants
Silicone nose implants are also sometimes used to reshape and sculpt the nose. Nevertheless, nose implants come in limited sizes and shapes – they aren’t as diverse as cartilage grafts. They can’t be sculpted to perfectly fit your needs.
Moreover, patients may experience silicone implant-related complications following their rhinoplasty, including:
- Soft tissue contraction
- Nasal structure deformity
- Implant displacement
- Skin thinning
Dr Jeremy Hunt prefers using grafts over implants to avoid these complications and give your nose a more natural look.
FAQs about Cartilage Grafting Nose Jobs
Is ear or rib cartilage better for rhinoplasty?
- Ear cartilage is generally safe and easy to harvest. It can also be easily sculpted, softened, and used to recontour the nose. However, there’s only a limited amount of cartilage that can be used from the ear. When it’s depleted, cartilage from the rib might be a suitable replacement.
Does cartilage grow after rhinoplasty?
- The cartilage that is trimmed or removed during a nose job, or damaged during an accident, cannot repair or grow back on its own. Cartilage from different locations in the body (septum, ears, and ribs) can be used as grafts to compensate for the lost nasal cartilage.
Can I change the shape of my nose cartilage?
- The shape of your nose is defined by the organisation of its internal structures including the bones and cartilage. During a rhinoplasty, both your nasal bones and cartilage can be changed and reshaped to change the appearance of your nose and/or improve its functions.
Is cartilage removed during rhinoplasty?
- During a nose job, cartilage can either be removed or added to change the nose’s shape and alter its functions. If too much cartilage is removed during a first rhinoplasty, cartilage grafts can be added during a second nose job to make up for the lacking cartilage and repair the nose.
Further Reading about Nose Surgery
- Read Dr Hunt’s Nose Surgery page
- Read Dr Hunt’s Rhinoplasty page
- See Dr Hunt’s Real Patient Nose Surgery Before and After Photos
- Blog How to find the Right Nose Surgeon in Sydney
- Blog Ethnic Rhinoplasty – A Nose Job for Different Ethnic Groups
- Blog Nose Bridge Rhinoplasty
Medical References about Cartilage Grafting Rhinoplasty
- Grafting in revision rhinoplasty – PMC
- The conchal cartilage graft in nasal reconstruction
- [Cartilage grafts in functional and aesthetic rhinoplasty]
- Cartilage grafts for the nasal tip
About Dr Jeremy Hunt – Specialist Plastic Surgeon
Dr Jeremy Hunt is a specialist plastic surgeon performing breast, body, face and nose surgery. He is a member of FRACS & ASPS and has over 20 years of experience providing cosmetic and plastic surgery in Sydney.
Dr Hunt’s personal, one-on-one service and attention to detail has ensured that thousands of women and men from the Sydney & Wollongong NSW area and across Australia have received high quality surgical care.
Dr Hunt’s qualifications and education
Dr Jeremy A Hunt MBBS FRACS graduated with a Bachelor of Medicine degree from Sydney University in 1990 and is a Fellow of the Royal Australasian College of Surgeons and member of ASPS – the Australian Society of Plastic Surgeons. He completed a Fellowship at the prestigious University of Texas in the United States, where he learnt from some of the world’s very best plastic surgeons.
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