Rhinoplasty after two-jaw surgery — choosing between septal cartilage and donor rib cartilage

2024. 7. 1.

Three questions when choosing rhinoplasty material in a state where septal cartilage is lacking after two-jaw surgery — side effects of over-harvesting septum, validity of supplementing with ear cartilage, and the pros·cons of donor rib cartilage organized from the director's answers.

Key points

For rhinoplasty material when septal cartilage is lacking after two-jaw surgery, it's hard to say uniformly which is better — it's a matter decided after checking nose shape, degree of upturning, and whether the septum provides support.
Septal cartilage plays a role supporting the nose at its center — so over-harvesting can let the nose sink, which is why other cartilage supplements when it's lacking.
When the septum is lacking, supplementing with ear cartilage is the most common method — and donor rib cartilage spares your own cartilage but has the drawback of not being autologous tissue.

"Since I've had two-jaw surgery, they say little septal cartilage remains. Clinics divide between ones proposing donor rib cartilage and ones proposing supplementing remaining septum with ear cartilage — which is right?"

This is a crossroads people researching rhinoplasty after two-jaw surgery actually encounter often. The person who sent this question wanted upturned-nose correction and was torn between wanting autologous cartilage after hearing bad things about donor rib cartilage — and worrying whether using up all the functional septum might cause problems.

This article organizes the answers to those three questions.

Material selection — why can't we say which is better?

Many people share a similar worry, but it's hard to settle which is better — because each person's nose shape differs slightly. It's a matter to decide after checking several factors: the current nose shape, degree of upturning, and whether the septum is supporting the nose.

In other words, rather than asking "is donor rib cartilage a good material," asking "which material combination fits my nose's conditions" matches the right order. Let's look at the three things the asker wondered about in order.

What problems can occur if a lot of septal cartilage is used?

Septal cartilage sits at the nose's center and plays a role propping up the nose. Because it carries this support role, over-harvesting can let the nose sink down.

So when the septum is lacking, over-harvesting is avoided by using other cartilage instead of forcibly taking more. The worry "is it okay to use up cartilage that has a function" is a valid one — and actual surgery likewise judges in that same direction: leaving as much as must be left.

Is supplementing with ear cartilage okay when the septum is lacking?

As a surgical method there's no problem. When the septum is lacking, the most commonly used method is supplementing the remaining septum with ear cartilage. If you want to proceed with autologous tissue in a state with little septal margin — like after two-jaw surgery — it's a naturally considered option.

Is using donor rib cartilage okay?

Every surgery has pros and cons. Organizing the two options:

Material combination	Advantages	Disadvantages
Remaining septum + ear cartilage	Proceeds with autologous tissue; the common method when septum is lacking	The amount of usable cartilage is limited
Donor rib cartilage	Ear cartilage and septum don't have to be used	Not autologous tissue

Using donor rib cartilage has the advantage of sparing ear cartilage and septum, but the drawback of not being autologous tissue. What matters is that surgery doesn't go wrong because of the material. The standard is choosing the material that fits the individual's nose state. Per-material traits can be seen in more detail in the materials guide.

Summary — not material superiority but your nose's conditions are the standard

Choosing rhinoplasty material after two-jaw surgery isn't a superiority contest of "donor rib vs autologous cartilage." The septum can't be over-harvested because of its support function, and whether to supplement the shortfall with ear cartilage or substitute with donor rib cartilage is a matter decided after checking nose shape, degree of upturning, and the septum's support state. If you're torn between conflicting consultation results, comparing what grounds each clinic proposed that material on helps.

If you're curious which material fits your nose state, it can be checked directly in a 1:1 video consultation. Actual correction cases can be seen in before-and-after photos.

Frequently asked questions

Answers to common questions patients ask before a consultation.

Does two-jaw surgery leave too little septal cartilage for rhinoplasty?

Like this asker, there are cases where people hear that little septal cartilage remains after two-jaw surgery. Since the septum is the center support structure and can't be over-harvested, when little remains, a direction supplementing with other materials like ear cartilage or donor rib cartilage gets reviewed.

Is donor rib cartilage a material to avoid?

It shouldn't be seen that way. Donor rib cartilage has the advantage of not using ear cartilage and septum, and the drawback of not being autologous tissue. Materials don't split into right·wrong on their own — choosing the material fitting the individual's nose state matters.

Which material should upturned-nose correction use?

It differs by degree of upturning, current nose shape, and whether the septum supports. The order is deciding the material combination after confirming those elements through an examination — and at the consultation stage it's good to hear an explanation of "why this material."

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.

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