Rib Cartilage Rhinoplasty & Revision

Procedure Overview

Implant-only rhinoplasty may present complications including extrusion, capsular contracture, infection, and nasal tip show-through in a proportion of cases. AVA Plastic Surgery's rib cartilage rhinoplasty harvests and refines the patient's own rib cartilage to reconstruct nasal structures, seeking to reduce foreign body rejection risk (individual results vary).

Our revision rhinoplasty algorithm follows the Stranc classification-based decision framework from Dr. Kim Seungsoo's published work (Park KS, Kim SS, Lee WS — Archives of Craniofacial Surgery, 2017, 18(2):97-104). Autologous cartilage application adheres to the anatomical principles from Gunter JP's Dallas Rhinoplasty.

Indications

• Patients with extrusion, show-through, or contracture following previous implant rhinoplasty
• Patients with infection or nasal tip deformity from prior rhinoplasty
• Cases where implant alone cannot provide adequate nasal tip support
• Complex dorsal hump or deviated nose correction requiring substantial structural support
• Multiple revision cases with depleted septal cartilage reserves

Why Autologous Rib Cartilage?

• Reduced Rejection Risk — Patient's own tissue carries lower immunologic rejection potential
• Long-Term Stability — Seeks reduced deformation and exposure risk over time compared to implants
• Abundant Supply — Sufficient volume available even when septal cartilage is insufficient
• Precision Sculpting — Customizable grafts for nasal tip, dorsum, columella, spreader grafts, etc.

Harvest Site & Process

Costal cartilage is harvested from the right 6th–7th rib through a ~3cm incision. The incision is designed along the bra line or existing scar to minimize visible exposure. Harvested cartilage undergoes refinement and sculpting before use in nasal structures (dorsum, tip, columella, spreader graft, etc.). Harvest site pain is typically most pronounced in the first 1–2 weeks post-surgery, gradually diminishing thereafter (individual variation).

Recovery Timeline (Individual Variation)

• 0–7 days: External splint and internal packing. Peak swelling and bruising.
• 7–14 days: Splint removal, suture removal. Return to daily activities possible.
• 1–2 months: 60–70% swelling resolution.
• 3–6 months: 80–90% swelling resolution, nasal contour settling.
• 6–12 months: Nasal tip sensation recovery, final shape stabilization.
• Harvest site: 1–2 weeks pain, gradual reduction thereafter. Scar stabilization 6–12 months.

Possible Adverse Events & Complications (Pre-Informed §56)

• Temporary/persistent swelling, bruising, pain
• Asymmetry, dorsal deviation — may change over time
• Nasal tip numbness 6–12 months (most recover)
• Rib cartilage warping — refinement and fixation techniques seek to reduce risk, but not 0%
• Harvest site pain, scarring, pneumothorax (rare)
• Infection, bleeding, hematoma — rare, but may require emergency treatment
• Nasal tip show-through or extrusion — lower risk than implant rhinoplasty, but not 0%

Academic References

1. Park KS, Kim SS, Lee WS, et al. "The Algorithm-Oriented Management of Nasal Bone Fracture according to Stranc's Classification System." Archives of Craniofacial Surgery 18(2):97-104, June 2017.
2. Gunter JP. Dallas Rhinoplasty: Nasal Surgery by the Masters. (Standard anatomical principles for autologous cartilage application)

Single-Surgeon System

Consultation, design, surgery, and aftercare are all performed by Dr. Kim Seungsoo. No subsequent patient schedule begins before the current patient's procedure is completed, ensuring no proxy surgery occurs.

Frequently Asked Questions (FAQ)

Q. I am concerned about rib cartilage harvesting.

Cartilage is safely harvested through a ~3cm incision. The scar is designed along the bra line or existing scar. Pain is most significant in the first 1–2 weeks post-surgery and gradually decreases (individual variation).

Q. Can I have only autologous cartilage without implants?

Yes. During consultation, nasal structure is evaluated to determine autologous cartilage alone vs. partial implant combination.

Q. Is autologous cartilage possible for revision cases?

Yes. Even if septal or auricular cartilage is depleted from prior surgeries, rib cartilage provides sufficient volume.

Q. How long is the recovery period?

External splint removal 7–14 days, return to daily activities 2–3 weeks, final shape stabilization 6–12 months (individual variation).

Q. What is the cost?

Cost varies based on revision history, correction scope, and cartilage volume. Detailed quote provided during 1:1 consultation. Transparent fixed pricing policy.

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