If you’ve been thinking about Rhinoplasty, then you’ve probably come across the term “cartilage rhinoplasty” or “cartilage graft Rhinoplasty/nose job” or something similar during your search. So, what is cartilage graft rhinoplasty? The short answer is that cartilage graft Rhinoplasty is a surgical procedure that helps reshape the shape of the nose with Cartilage grafts, also known as malleable tissue. The surgeon will harvest this tissue from either the ears (auricular), ribs (costal), or nasal septum (septal). It is also a common technique in augmentation Rhinoplasty.
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This complete guide to Nose Surgery covers everything you need to know about this procedure, including:
- Your surgery explained
- How to assess if you are a good candidate.
- Planning for your surgery
- Answers to most frequently asked questions.
- Before and after gallery
- Learn more on Rhinoplasty
What is Cartilage?
Cartilage is a flexible, tough connective tissue found in various parts of the body, providing structural support and reducing friction in joints. It comes in different types, including hyaline, elastic, and fibrocartilage, each serving specific functions.
While cartilage is solid, it’s much softer than bone, it is flexible and malleable. The lower half of your nose, your nose tip, and nasal septum are also made of cartilage.
What is cartilage graft rhinoplasty?
Cartilage graft rhinoplasty is a surgical procedure that involves using cartilage, often harvested from the patient’s own body (commonly the ear), to reshape and reconstruct the nose. This technique is commonly used in Rhinoplasty to reshape or modify the nasal structure, providing structural support or altering its shape to achieve the desired functional outcomes. Cartilage grafts address issues like nasal bridge augmentation, tip refinement, and overall nose reshaping.
If you’re looking to make your nose larger, your surgeon will have to either implant a synthetic implant (made of plastic or Gore-Tex) or use natural body tissue to reshape your nose. Cartilage is a natural body tissue and has been used for decades as graft material.
A cartilage graft means that your plastic surgeon will collect cartilage tissue from another part of your body, and incorporate that tissue when constructing and reshaping your nose. We can find cartilage in many sites of our body, however, surgeons commonly harvest it from the ribs, ears, or the nasal septum during rhinoplasty.
Cartilage Graft Nose Surgery – Candidates
A cartilage graft may be recommended for people who want to get an augmentation rhinoplasty to;
- Raise their nasal bridge,
- Reshape nasal projection
- Increase the size of their nose
- And/or augment their nasal tip (tip plasty)
Your ethnicity can impact your facial features and certain ethnicities require different surgical methods and approaches especially when it comes to facial surgery. What may work for Caucasian patients, may not for Asian, European or African American patients and vice versa.
Nose surgeries have become so popular among people of Asian descent, that there is now a specialised procedure known as “Asian Rhinoplasty”. Those of Asian heritage tend to have less developed nasal bones and cartilage, so the nasal bridge is usually convex and does not project much. The tip tends to be narrow, small, and without much protrusion. Asian patients and others request nose augmentation, which can be done using a synthetic prosthesis or cartilage.
Other conditions that might require augmentation rhinoplasty and cartilage grafting include;
- Those suffering from a Cleft palate
- Nose trauma
- And collapse or weakness in your nose cartilage that requires nose reconstruction surgery.
What are the different types of cartilage grafts used in nose surgery?
There are several types of Cartilage grafts that surgeons can use in Rhinoplasty and there’s debate over which one is the most suitable. Each type of Cartilage has advantages and disadvantages. Generally, it is your surgeon’s experience (and not the type of Cartilage) that is more important in determining the outcomes of Rhinoplasty.
There are three types of cartilage grafts for Rhinoplasty:
Septal cartilage graft
The septum is the wall of Cartilage and bone that separates the nasal cavities. During Rhinoplasty, the surgeon may use a small piece of septal Cartilage to reshape the nose. This technique may be more common in some patients.
When possible many surgeons choose septal nose Cartilage for augmentation Rhinoplasty over other types of Cartilage. Furthermore, as the tissue is from the nose itself, it’s more likely to adapt when re-implanted. This also makes the septal Cartilage less likely to bend or warp over time compared to the other types.
Ear cartilage graft
Other terminology for this procedure include conchal or auricular cartilage graft. This method requires the surgeon to harvest the Cartilage from the bowl of your ear. You must know that this will not in any way change how your ear looks, and won’t leave any visible outer scars.
Ear Cartilage is softer than septal Cartilage, which means it’s easier to reshape and reshape into the desired shape. This high malleability and natural curvature of ear Cartilage make it a desired option for nose tip augmentation and reshaping (tip plasty). Your surgeon will cut and reshape the auricular Cartilage into small pieces during nose tip surgery and will then strategically implant the Cartilage to alter nasal tip projection
Rib cartilage graft
This is also called costal cartilage grafting. The main advantage of using costal cartilage in Rhinoplasty is that there’s a large amount of it available to harvest without causing any functional disturbances to the ribs. Costal cartilage is firmer, but it’s more likely to warp and lose its shape over time. Another disadvantage is that it requires more operative time, and as a result, it increases both the direct and indirect costs of surgery. Costal cartilage nose jobs are usually reserved for cases where extensive nose reconstruction is necessary.
Usually a Nose augmentation with cartilage grafting uses the open nose job technique (as pictured below). Your surgeon will cover the cartilage with normal tissue to hide it so it’s not visible under the skin. When the surgeon is happy with the size and shape of your nose, They will close the incision using dissolvable or non-dissolvable stitches. Scars are generally concealable in the skin fold under your nose.
What are the advantages and disadvantages of artificial nose implants?
Artificial nose implants, also known as synthetic or alloplastic implants are usually made of silicone or Gore-Tex. Like any surgical technique, they come with both advantages and disadvantages.
- Predictable Outcomes: Artificial implants provide precise control over the desired shape and size of the nose, leading to predictable results.
- Reduced Time in Surgery: Using artificial implants can reduce the time needed in surgery compared to grafting from the patient.
- No Donor Site: Unlike autologous grafts (using a patient’s own tissue), artificial implants eliminate the need for a donor site, which can reduce the risk of additional complications.
- Risk of Complications: Implants can carry a higher risk of complications like infection, extrusion (the implant breaking through the skin), and displacement.
- Less Natural Feel: Artificial implants may not feel as natural as using the patient’s own cartilage or tissue.
- Long-Term Risks: There’s a risk of long-term issues, such as implant visibility or distortion over time.
- Limited Material Options: There are only a few materials suitable for implants, and the choice may impact the final result and potential risks.
- Rejection or Allergic Reactions: In rare cases, patients may experience rejection or allergic reactions to the implant materials.
It’s essential for patients considering artificial nose implants to discuss the advantages and disadvantages with their surgeon, weighing the risks and benefits to make an informed decision that aligns with their aesthetic goals and overall health.
How long do cartilage grafts take to heal?
A rhinoplasty (with cartilage grafting), will require at least 1 to 2 weeks of rest at home. During this time, the swelling will subside, the bruising will improve, and there will be less discharge from your nose. However, you should wait at least 6 weeks or until cleared by your surgeon before you return to any contact sports.
Read more about Reduce Bruising and Swelling After Rhinoplasty or Septoplasty.
Does Medicare cover rhinoplasty?
If the procedure is purely cosmetic, you will not be eligible for cover from Medicare. However, if the nose surgery is medically necessary due to either breathing difficulty, nose deformity or nose trauma, you may be eligible for a rebate that will cover some of the cost. However, you will still have out of pocket costs.
Read more about Will Medicare cover my Rhinoplasty or Nose Surgery?
How to Find a Rhinoplasty Surgeon for you
When looking for a nose surgeon to complete your procedure, doing research is vital. You need to ensure that the person you choose not only has the qualifications and the experience to perform your procedure but also the before and after photos and testimonials from past patients.
Dr Stephen Kleid – Ear Nose and Throat Surgeon
MBBS – Bachelor of Medicine/Bachelor of Surgery and Bachelor of Medicine
FRACS – Fellow of the Royal Australasian College of Surgeons
Dr Stephen Kleid is an experienced Ear, Nose and Throat (ENT) Surgeon (Otolaryngologist) based in Melbourne with a passion for Rhinoplasty, Septoplasty and a strong interest in Rhinoplasty Revision.
If you want to find out more about a procedure book a consultation.
Further reading about Nose Surgery
- 6 Common Nose Shape Concerns that Rhinoplasty can resolve
- Open vs Closed Rhinoplasty Surgery
- Rhinoplasty – Nose Reshaping Surgery in Melbourne by Dr Stephen Kleid