Autologous Rib Cartilage Rhinoplasty: Choosing the Approach That Suits Me

The nose, located at the center of the face,

plays a major role in creating

bilateral symmetry and dimension.

As it helps determine a person's overall impression,

it has long received considerable attention.

After the period when

artificial implants such as silicone

and AlloDerm were inserted,

implant-free approaches using

a person's own tissue

began to gain popularity.

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The types of autologous tissue include

ear cartilage, which many people are familiar with,

as well as septal cartilage, autologous dermis,

and rib cartilage. In this article,

we will focus on autologous rib cartilage rhinoplasty.

This procedure refers to an approach

that uses tissue from one's own body

or tissue donated by another person

instead of artificial materials such as silicone.

Because part of one's own body

is processed and inserted,

the risk of immune or inflammatory reactions

is low, and it also has the advantage

of producing a natural appearance.

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Because of these advantages,

many people choose it

when attempting surgery again

after an unsuccessful first procedure.

In particular, autologous rib cartilage rhinoplasty

is an approach recommended for people

who want to raise the bridge of the nose

while maintaining both a natural appearance

and firm support.

Although the proportion of people

receiving autologous rib cartilage rhinoplasty

has increased recently,

this approach is not always

the right answer.

Artificial implants may instead be suitable

for people who prefer a more dramatic appearance.

On the other hand, there are also cases

in which rib cartilage is unavoidable.

Rib cartilage may be harvested and inserted

when a particular area requires strong support

or when the cartilage in the nose or ears

has already been fully used.

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As suitability differs from person to person,

and the materials that can be used

also vary considerably,

it is essential to have a thorough discussion

with the physician in charge

before proceeding with the approach.

Next, let us look at the types of autologous tissue

and their purposes.

The body tissues used in implant-free approaches

include ear cartilage,

septal cartilage, rib cartilage,

and autologous dermis.

Ear cartilage is, as the name suggests,

harvested from the ear,

while the septum is the tissue

located in the midline inside the nose.

Rib cartilage comes from the area around the ribs,

and autologous dermis is harvested

from the buttocks, where fat is abundant.

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Because these tissues come from one's own body,

immune or inflammatory reactions

rarely occur. However,

because the outcome varies depending on

how the tissue is processed,

the medical team's experience

and technical expertise are essential.

The septum primarily uses tissue

left over after treatment for a deviated septum.

Because it is harvested by excision

from inside the nose,

it does not leave much of a scar,

but the amount available is limited.

It is mainly finely ground or processed

and inserted into the nasal tip

to create a more defined nose shape.

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Ear cartilage is autologous tissue

that has been frequently used for a long time.

It is less likely to show through the skin,

and one of its advantages is

that the improved shape looks natural.

Autologous dermis is used to provide additional volume

when the skin on the nasal bridge is thin

and an implant shows through,

or when soft tissue is insufficient.

Autologous rib cartilage rhinoplasty

uses rib cartilage.

It is obtained from the chest area

and has the greatest hardness

among the materials mentioned above.

Because it is very firm,

it is used to raise the nasal bridge,

and it also has the advantage

of being less likely to deform easily.

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It offers the benefit of being more abundant

than cartilage from the nose or ears,

but a scar may remain near the ribs.

The mark gradually fades,

but depending on the nature of the skin,

it may become discolored

or protrude as a keloid.

This should be understood in advance.

In the past, autologous rib cartilage rhinoplasty

was generally performed as a revision procedure

after an unsuccessful first attempt.

Recently, however,

more people have wanted an approach

using rib cartilage from the beginning.

This is because a high and dramatic shape

can be created using only autologous tissue,

without silicone or AlloDerm.

Because rib cartilage is as firm as an artificial implant,

it can be used to create a more Western-style nose.

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Another reason is that the amount of material

that can be harvested from the ear or septum

is limited.

Septal cartilage generally needs to measure

at least 30 mm in both width and height

to provide a sufficient amount for harvesting.

If it is smaller than this,

the amount may be insufficient,

resulting in an outcome that is

worse than not undergoing the procedure.

For these reasons, rib cartilage

has become increasingly preferred.

In addition, its popularity continues to rise

because of its low absorption rate

and versatility.

Autologous tissue has the advantage

of rarely causing allergic reactions

or a foreign-body sensation,

but one disadvantage is

that some of it may be absorbed.

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For this reason, after an implant-free procedure,

the nasal bridge may become

slightly lower after some time has passed.

Rib cartilage has a relatively low absorption rate,

so the changed appearance can be maintained

for a longer period.

Its uses are also very diverse.

It can improve most nasal concerns,

including not only a broad nasal tip,

such as a bulbous nose,

but also an arrow-shaped nose,

a hump nose, an upturned nose,

and a contracted nose.

To maintain the changed appearance

without complications,

thorough postoperative care is necessary.

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As long as you follow the instructions

provided by the medical institution,

you generally will not experience

adverse effects.

Until the tissue has stabilized,

care must be taken to prevent strong pressure

from being applied to the area.

You should also avoid blowing or rubbing

your nose forcefully.

Alternating cold and warm compresses

may also help relieve swelling

and speed up recovery.

Sleeping while reclining at an angle

of about 45 degrees can also help

reduce swelling.

Autologous rib cartilage rhinoplasty

is a highly complex approach involving

multiple stages, from tissue harvesting

and processing to insertion.

Therefore, the medical team's expertise

should be considered the top priority.

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Although the financial aspect cannot be ignored,

you should thoroughly investigate

whether the physician in charge

has extensive experience and expertise

with this procedure,

whether they develop and propose

a personalized design,

and how the postoperative care process

has been established,

before making a careful decision.

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