Is rib-cartilage rhinoplasty the only option left — the order to check when ear cartilage is used up
2024. 10. 2.
If both ear cartilages were already used in revision, is rib cartilage the only option? The order of checking septal cartilage first, the criteria for moving to rib-cartilage surgery, and how to judge a suture poking out of the incision — organized from a real consultation answer.
Key points
- Even if both ear cartilages were already used, the option of using the septal cartilage inside the nose may remain.
- If septal cartilage has been used too, review reconstruction materials including rib cartilage — but check the remaining support structure and needed correction amount first.
- If a suture is visible or palpable at the incision site, don't pull or cut it yourself — have the wound and suture type checked at the clinic where you had surgery.
"They said both cartilages are used up, so if I want another surgery I'd have to do rib-cartilage rhinoplasty — is there really no other way to lift the tip?"
This is a real consultation question from someone deliberating on revision. After the first nose surgery the tip drooped and the bridge was low, so they got a revision right away — and heard that both cartilages were used up in the process. They also asked whether it's possible that suture-like material poked out and was palpable at the columella incision (inside the nostril), with a blue suture coming out days later.
This article organizes the answer to that question.
01
If ear cartilage is used up, is rib cartilage the only option?
Here, "both cartilages are used up" appears to refer to ear cartilage. Even if ear cartilage is fully used, going straight to rib cartilage isn't mandatory.
The method of using the septal cartilage inside the nose comes first. Organizing the autologous cartilage usable in revision in order:
- Ear cartilage — in this case, both sides already used.
- Septal cartilage — if it remains inside the nose, the next material to check.
- Rib cartilage — the option to proceed if the septum is used up too.
So rather than rib-cartilage rhinoplasty being the only answer, the order is checking what material and support structure remain inside the nose now. If septal cartilage was also used in the previous surgery, the range is set by comparing the pros·cons of other reconstruction materials including rib cartilage.
02
When does rib-cartilage rhinoplasty proceed?
When no autologous cartilage to support and raise the tip remains around the nose — like a revision where both ear and septal cartilage were used — chest-side rib cartilage is used.
For the tip not to droop again in revision, a material and support structure to hold it up is needed — and if no material remains, rib cartilage takes that role. How rib-cartilage surgery actually proceeds can be seen in the autologous rib-cartilage RIBFIT™ guide; the criteria for judging materials in revision are covered in more detail in the revision rhinoplasty guide.
To summarize, it divides like this.
| Material remaining | Choice |
|---|---|
| Septal cartilage remains | Tip support·extension possible with septal cartilage |
| Septum fully used too | Proceed with rib-cartilage rhinoplasty |
03
A suture poked out at the incision site — is it a problem?
A suture can sometimes feel rough or show outside at the incision inside the nostril. Still, whether it's a dissolvable suture, one needing removal, or whether the wound has opened or inflammation accompanies it must be checked directly.
Pulling or cutting a visible suture yourself can irritate the wound. Leave it untouched and have it checked at the clinic where you had surgery, by photo or visit — and if redness·swelling·pain·discharge accompanies it, get examined without delay.
04
Summary — rib cartilage is a question of order
Even if you heard "rib cartilage is the only option," the actual order is checking the septal cartilage and support structure remaining inside the nose. If the septum is used too, pros·cons of reconstruction materials including rib cartilage are compared. Since revision plans differ by remaining material and tip state, reviewing previous surgical records together with a current exam is the first step.
If you're curious what material remains in your nose, you can get direct verification in a 1:1 video consultation.
Frequently asked questions
Answers to common questions patients ask before a consultation.
They said my ear cartilage is used up — is there a way to lift the tip besides rib cartilage?
How can I know whether septal cartilage was already used too?
A suture came out inside my nostril — should I complain to the clinic?
Responses to treatment and recovery progress vary by individual. Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.