When do you decide to do rib, ear or nasal septal cartilage and what are the options for raising your nasal bridge?

Cartilage grafting is the best way to augment the nose during Rhinoplasty(or nose job / plastic surgery of the nose / cosmetic surgery of the nose / rinoplasty / nose plastic surgery). It is the least likely to have infection and rejection issues. The progression of cartilage grafting is usually nasal septum, ear cartilage, then rib cartilage. Septal cartilage is the most accessible but often is limited in quantity. Significant nasal bridge augmentation may require more than what the septum can offer. Ear cartilage offers more but the bend in ear cartilage makes it less attractive for the nasal bridge but can be used for small augmentations. Rib cartilage usually is needed when the nasal bridge needs to be raised a significant amount. When you start to consider the whole nasal bridge and if it is more than 2-3mm in change, you should start to consider rib as an option. You can also consider a silicone implant. Although this is a foreign object the rejection is really low if the implant is done right.  There are limits to how big you can make your nose.  The limiting factor is the skin envelope and the lining of the nose.  Making it much bigger than what it used to be is hard.  There is really no science that is out there yet to determine how much bigger one can make the nose.  An adequate release of the tissues to allow the rib or other graft to expand the skin is necessary.

Thanks for reading, Dr Young

Dr Young specializes in Facial Cosmetic and Reconstructive Surgery and is located in Bellevue near Seattle, Washington

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