Choosing the Cartilage Source in Revision Rhinoplasty

Revision rhinoplasty may be considered when, after the first surgery, conditions such as:

• nasal tip drooping
• cartilage weakness
• collapse
• asymmetry
• breathing problems
• loss of support in the nasal framework

occur.
For this reason, some patients may need additional supporting tissue.

In revision rhinoplasty, the choice of cartilage source is an important step in surgical planning.

Three Main Cartilage Sources Used In Revision Rhinoplasty

1) Intranasal (Septal) Cartilage

• It is a natural source.
• In revision cases, it may sometimes have been harvested previously.
• If available in sufficient amount, it is the first source evaluated.

2) Ear Cartilage (Conchal Cartilage)

• It is suitable for minor corrections.
• Due to its soft structure, it is easy to shape.
• It may be preferred for nasal tip procedures or limited repairs.
• Appropriate techniques are used to avoid deformity of the ear.

3) Rib Cartilage (Costal Cartilage)

• It is a stronger and more voluminous cartilage.
• It is considered in cases requiring substantial support.
• It may be necessary in collapse, marked asymmetry, or advanced deformities.
• Because it provides sufficient volume, it is one of the preferred options in some revision cases.

How Is The Cartilage Source Selected In Revision Rhinoplasty?

For each patient, the following parameters are evaluated:

• The condition of the existing intranasal cartilage
• Skin thickness
• The degree of loss of support
• The projection needs of the nasal tip
• Which surgery number it is
• Previous traumas
• Breathing status
• Evaluation of long-term structural needs

Based on these analyses, planning is done as follows:

• If a minor correction is needed → Ear cartilage
• If there is sufficient cartilage inside the nose → Septum
• If stronger support is required → Rib cartilage

The cartilage source selection is not the same for every patient, and planning is based on an individualized evaluation.

Is Rib Cartilage Mandatory?

It is not always necessary.

In the following situations, rib cartilage may be a more suitable option:

• If the septum has been largely harvested in previous surgeries
• If there is significant collapse in the nasal framework
• If nasal tip support has weakened
• If there is a significant loss of strength in the bone and cartilage structure
• If a stronger structure is required due to skin thickness

What People Wonder About Cartilage Source Selection In Revision Rhinoplasty