In the Operating Room - Rib Cartilage Carving for Revision Rhinoplasty

www.rhinoplastyspecialist.com Rib cartilage is a natural and only autologous source that can offer an unlimited amount of cartilage that has more than adequate lengths. One of the main advantages of rib grafts is its plentiful supply. However, rib grafts are almost always curved and cartilage is well known for its memory. (recall of shape) As a result, it has a tendency to warp or return somewhat to its original shape despite being carved and shaped. Symmetric concentric carving of the rib cartilage will lessen the incidence of postoperative warping. Another way to prevent warping is to insert a thin metal pin through the graft to keep it straight. The most common reason for a rib graft rhinoplasty is the saddle nose deformity. Correction of this nasal problem requires a significant amount of graft material. The rib graft is carved and reconstructed by assembling it into a two-piece L-shaped graft which is placed through an open rhinoplasty. A longer larger piece is shaped into a dorsal graft and a smaller piece into a columellar strut. If an intact septum is present, then only the onlay dorsal graft will be needed to correct the deformity. Careful graft carving and assembly is needed to minimize the risk of graft warping. Once positioned, the tip cartilages (dome) can be sutured over the end of the rib grafts. http Spalding Drive Cosmetic Surgery and Dermatology 120 S. Spalding Drive Suite 315 Beverly Hills, Ca. 90212 Tel: (310) 275-2467



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