Q. Is autologous rib cartilage okay for a primary nose surgery? Are there nose types that must be done with autologous rib cartilage?

Hello. I’m Dr. Seo Chan-eol from AB Plastic Surgery.

I’ll answer the nose surgery questions many of you have been wondering about!

Q. Is autologous rib cartilage okay for a primary nose surgery? Are there nose types that must be done with autologous rib cartilage?

When considering a first nose surgery, many people think using rib cartilage is excessive.

That is probably because it is an unfamiliar material, so many people wonder, “For nose surgery, do they really take cartilage from the ribs?”

However, rib cartilage has many advantages and is an autologous material that is used at a high rate for the nasal tip. Among this “rib cartilage,” using cartilage taken from one’s own body is called “autologous rib cartilage” (hereafter, autologous rib).

Compared with other human tissue materials (septal cartilage, ear cartilage, donor rib cartilage, etc.), “autologous rib” is the hardest in strength and has the advantage of being able to provide a long length even with an incision of about 2 cm on average. When it can be obtained in a long piece, there is a plentiful amount of cartilage, so it can be most usefully used to support the height of the nasal tip or strengthen the internal structure.

Even for a primary nose surgery, I think autologous rib is an “adequate” and “not excessive” material if it is “appropriate for the case.”

Types for which autologous rib is suitable include cases where septal cartilage or ear cartilage is insufficient to create the desired nasal tip height, cases where the skin is firm and thick, and cases where lengthening the nose is needed while reducing the columella.

If human tissue materials such as septal cartilage or ear cartilage are insufficient for creating the desired nasal tip height, one could consider adding to the existing cartilage or a floating-type structure. However, long term, there may be a problem of the nasal tip drooping. Also, using artificial materials such as L-shaped silicone or mesh that extend into the columellar pillar may cause future problems, so these are not considered recently. In such cases, even for a first surgery, autologous rib may be more suitable.

When the skin is firm and thick, lifting the nasal tip increases the pressure. In such cases, to prevent the material from being absorbed or the structure from collapsing over the long term, a material with little absorption and strong durability is suitable, so autologous rib is appropriate. Even when lengthening the nose while reducing the columella, the material must be strong enough to withstand the increased force, and a large amount of cartilage is needed, so in most cases autologous rib is more suitable.

Today, we looked at autologous rib as a human tissue material for raising the nasal tip, whether it is also appropriate for a primary nose surgery, and the types for which autologous rib is more suitable. Because everyone’s original nose thickness, length, and height are different, and because the desired or well-suited nose shape and height also differ, the human tissue materials used for the nasal tip, as well as whether nasal bridge silicone is used and what type is used, will vary. Therefore, I think visiting the clinic and consulting with a specialist would be helpful.

If you have any other questions, please leave a comment.

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