Is Autologous Rib Rhinoplasty Natural? — A Case Resolving a Drooping Tip and Low Glabella Together

01

How are a drooping tip and low glabella resolved together?

This patient's tip drooped downward, giving a heavy, stuffy atmosphere in both front and side views, and the glabella lacked height so the bridge's starting point felt weak. In such cases, rather than raising only the tip or adjusting part of the bridge, a process that forms the whole flow from glabella to tip together matters.

What was done in this surgery is as follows.

• Tip direction correction — the downward-drooping tip was organized upward through tip cartilage repositioning and tip cartilage binding.
• Support structure formation — a stable support structure was made between the cartilages so the drooping feeling would not recur over time.
• Bridge line formation — using RIBFIT™, a height continuing naturally from the glabella was created, adjusted so the whole bridge flow connected smoothly in proportion to the face.
• Angle balance — considering the columella, nasolabial angle, and philtrum line balance, the tip was adjusted so it would not look excessively lifted.

02

How does RIBFIT™ differ from ready-made implants and other autologous tissue methods?

RIBFIT™ is a custom-form structure fabricated from autologous rib cartilage, with the characteristic of allowing finer adjustment to fit the individual's skeleton and skin condition.

RIBFIT™ is one option with a different fabrication process. Whether actual absorption rate, shape retention, and revision rate are superior to other materials or methods must be separately verified through comparison data. What kind of structure RIBFIT™ is can be seen in more detail in the RIBFIT™ autologous rib cartilage guide.

03

Can autologous rib cartilage be used in a nose that has had multiple surgeries?

The second case had surgery about 7 years earlier with donor rib cartilage, ear cartilage, and silicone, then went through an additional revision — yet a gap from the desired flow remained. The hump area had been trimmed in the previous surgery but the dorsum line was not completely smoothed, and a feeling remained that the nose looked somewhat short. Irregularity was noted mid-dorsum, with slight nostril asymmetry.

Since this was already a third surgery, autologous rib rhinoplasty was chosen in consideration of a more stable direction, and planned to also refine the nasal width for a clearer image. The dorsum and hump that remained uneven were organized with osteotomy, and instead of a separate implant, rib particles were used on the bridge to compose a naturally continuing flow. After surgery the dorsum width was refined, the tip line became slimmer, the mid-dorsum that had looked sunken connected smoothly, and the side nasolabial-angle flow was balanced. The actual change can be checked in the before-and-after photos.

One thing to note is absorption and shape change. The original text explains that autologous rib cartilage's change potential is estimated at about 10–20% and the initial height is set higher — but no independent basis was confirmed for applying this figure to all patients. Initial height must be decided individually within a safe range by evaluating material form, processing and fixation method, and skin/scar tissue condition together. At about one month after surgery, the tissue is still stabilizing, so it is too early to determine the final form.

04

Summary — flow and absorption go into the plan

For a nose where a drooping tip and low glabella coexist, the whole flow from glabella to tip must be examined together rather than adjusting one part. Autologous-rib-based RIBFIT™ is an option compression-molded in a custom mold, and for noses that have had multiple surgeries, the remaining cartilage, skin, and scar tissue and the required support must be evaluated first. Absorption and shape change are also reflected in the plan per individual conditions rather than as one fixed figure. If you are weighing a direction after multiple surgeries, the direction fitting your current nose condition can be checked in a 1:1 video consultation.