The Role of Cartilage in Revision Rhinoplasty

Revision rhinoplasty is performed to make aesthetic or functional corrections when previous nose surgeries do not achieve the desired results. In these surgeries, additional cartilage is often required to shape and support the nose. Since the nasal cartilage may have been used in previous procedures, it is often necessary to obtain cartilage from other parts of the body or alternative sources. The advantages and disadvantages of the three main types of cartilage preferred in different cases are detailed below.

Sources and Applications of Cartilage

Rib Cartilage

Cartilage taken from the rib area is ideal for major structural corrections. It is particularly effective in correcting severe deformities or irregularities.

Advantages:

• Durable and available in large quantities.
• Since it is the patient’s own tissue, there is no risk of rejection.
• Its structural strength provides shape support and long-term durability.

Disadvantages:

• Harvesting it requires a second surgical incision in the rib area.
• There is a risk of warping (shape distortion).
• The healing process in the rib area can be more challenging.

Ear Cartilage

Cartilage taken from the ear is often preferred to support or shape the nasal structure. It is especially effective for smaller corrections.

Advantages:

• The surgical incision is usually small and made in an inconspicuous area.
• Its flexibility makes it a suitable material for nasal aesthetics.
• Since it is the patient’s own tissue, there is no risk of rejection.

Disadvantages:

• Its quantity is limited, so it may not be sufficient for large structural corrections.
• Harvesting it can leave a suture scar, but this generally does not create a significant asymmetrical appearance.

Radiation-Processed Cadaver Cartilage

Cartilage obtained from donors and sterilized is used when the patient’s own tissue is insufficient. It offers an alternative in complex cases.

Advantages:

• Does not require a second surgical incision in the chest or ear area.
• Can be obtained quickly and easily.

Disadvantages:

• There is a risk of weakening or rejection over time.
• Its durability is lower compared to natural tissues.
• It is more expensive.

Proper Selection and Planning

The type of cartilage to be used depends on the patient’s needs, nasal anatomy, and surgical goals. Surgeons perform a detailed evaluation to determine the most suitable option. This evaluation typically includes the following factors:

• History of Nasal Surgery: The amount of cartilage used in previous surgeries and its current condition.
• Nasal Anatomy: The durability of existing tissue and the need for new support.
• Surgical Goals: Whether aesthetic corrections or functional improvements are being made.

With proper planning, both aesthetic and functional success can be achieved. The surgeon’s expertise plays a critical role in the correct selection and application of cartilage. Providing patients with detailed information before and after surgery ensures a more transparent and successfully managed process.