Rib cartilage revision — must the bridge be lowered? Criteria for setting height and whether material remains
2024. 10. 31.
If your septum has collapsed and rib cartilage revision is ahead — why the previous harvest site·chest wall state and remaining nasal structure must be evaluated to decide material and bridge height.
Key points
- The mere fact that there are several rib cartilages can't guarantee re-harvesting is possible. The previous harvest site·chest wall state·required amount are checked.
- Rib cartilage is indeed a sturdy material, but if the septum is bent or weak, the nose can look crooked — so it can be said that the height can't be raised much.
- Whether height can be raised or must be lowered is hard to state without directly seeing the nose and septum state — the more revision, the more cautious the approach.
"The clinic that operated on me wants to lower the bridge, but another clinic says they can do the height I want. Why do they say different things?"
We received a question from someone confused by different answers from different clinics while awaiting revision surgery for a collapsed septum.
This article organizes — as actual questions and answers — the criteria for setting bridge height in rib cartilage revision and the worry about whether revision material remains.
01
The actual question — rib revision, and they want to lower the bridge
Q. I had rhinoplasty 3 months ago. Silicone was placed on the bridge, and septal and ear cartilage at the tip — but the septum collapsed, so I'm waiting for autologous rib cartilage revision. I have two questions.
- I'll end up using septal cartilage, ear cartilage, and even autologous rib cartilage — if this surgery also goes wrong, what material can be used then? Can rib cartilage revision be done twice?
- I have 4mm of silicone in place, and the clinic that operated wants to lower the bridge this time. They say the tip must also be lowered overall so the septum doesn't collapse. I prefer a high nose, so then the surgery feels pointless. Other clinics say they can keep the current state and do the height I want — why does the operating clinic say it can't be done? Rib cartilage is a sturdy material — would the septum collapse from raising it a little?
Let me answer one by one.
02
Can rib cartilage revision be done twice? Is material left?
Whether re-harvesting is possible is judged after checking which rib cartilage was harvested how much before, chest wall deformity·pain·scarring, and the cartilage amount needed.
| Situation | Remaining options |
|---|---|
| Autologous rib cartilage already used once | Evaluate re-harvest possibility via surgical records and chest wall state |
| Additional harvest is hard or burdensome | Compare options and limits — donor rib·ear cartilage·remaining septum etc. |
A material list alone doesn't promise the next surgery is possible. The support needed for this revision and donor-site risk must be weighed first. Surgery using autologous rib cartilage can be seen in more detail in the autologous rib cartilage guide.
03
Rib cartilage is sturdy — why would they want to lower the bridge?
Whether height can be raised further with rib cartilage, or must be lowered from now, is hard to state without directly seeing the nose and septum state. The differing answers between clinics may ultimately come down to each having judged a different state.
The reason for lowering should be explained specifically by the operating team — the septum·nasal bones·skin·scar tissue and needed support, and the cause of the previous failure. Rib cartilage's strength alone doesn't mean the whole nasal structure safely supports the desired height.
In this questioner's case, the septum has already collapsed and revision is underway. Since it's a revision, an even more cautious approach seems warranted. What gets checked in revision can be referenced in the revision rhinoplasty guide.
04
Summary — state evaluation comes before height
Revision height is decided by evaluating not just rib cartilage strength but the previous failure's cause and the septum·nasal bones·skin·scar tissue together. Autologous re-harvest or donor rib use isn't automatically possible either, so surgical records, nose·chest wall state, and donor-site risk are checked.
If you're curious how high is possible given your septal state, you can get it checked directly in a 1:1 video consultation.
Frequently asked questions
Answers to common questions patients ask before a consultation.
If septal·ear·rib cartilage are all used, is no revision material left?
Rib cartilage is sturdy — why would raising it cause collapse?
Why do clinics differ on the achievable height?
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.