Where Is Cartilage Taken From in a Second Nose Surgery (Revision Rhinoplasty)?

In revision (i.e., second) rhinoplasty, in some patients the existing cartilage tissue inside the nose may have been reduced or weakened during the previous operation. This situation may lead to structural changes such as:

• Nasal tip drooping
• Loss of support
• Asymmetry
• Collapse (inverted V appearance)
• Difficulty breathing

Therefore, when planning a second surgery, additional cartilage support may be required.

What Are The Sources Of Cartilage?

Septal Cartilage (Intranasal Cartilage)

This is the first area evaluated for revision.

• It provides a natural reshaping opportunity.
• However, in many revision cases, it may have been harvested in the previous surgery or its amount may have decreased.

In which cases can it be used?

• If very little cartilage was used in the first surgery
• If minor corrections are needed
• If the need for support is minimal

Ear Cartilage (Conchal Cartilage)

Due to its soft and curved structure, it can be used especially in nasal tip adjustments.

Advantages:

• It is flexible
• It is compatible with mobile facial areas
• Since the incisions are behind the ear, it does not leave a visible scar
• Limitation:
• Its amount may not be sufficient in cases where large-volume support is required.

3) Rib Cartilage (Rib Cartilage)

It is considered in some complex revision surgeries.

• It provides a stronger and more voluminous structure.
• It has high moldability.

In which cases may it be necessary?

• If nasal tip support has significantly decreased
• If septal cartilage is insufficient
• If the existing cartilages were used in previous operations
• If there is structural collapse or severe deformity

Safety:

When harvested using appropriate surgical techniques, incisions are kept small and show healing over time.

Which Source Is More Suitable In A Second Surgery?

The choice of cartilage source is not the same for every patient. Planning is made according to the following criteria:

• The amount of existing support at the nasal tip
• Skin thickness
• The degree of loss of support
• History of previous surgery
• Functional needs

In short, the type of cartilage to be used in revision rhinoplasty is determined as a result of an individualized evaluation.