If you've had two-jaw surgery, can't septal cartilage be used? — a story about post-two-jaw rhinoplasty materials

2025. 1. 15.

During two-jaw surgery the lower part of the septum gets cut, so cartilage size usable for rhinoplasty can run short. Organized why septal state is checked by CT, the limits of ear cartilage, and the criteria for recommending rib cartilage.

Key points

When two-jaw surgery is performed, the lower part of the septum gets cut — so in many cases not enough cartilage remains for rhinoplasty.
Septal state is hard to check from outside so it's confirmed by CT scan — and considering size and safety, rib cartilage is often used.
Beyond size alone, the interior may have weakened from such a major surgery — so viewing cosmetic and functional issues together matters.

In rhinoplasty, septal and ear cartilage grafts are recommended first whenever possible — but when size is lacking or the cartilage is too soft, rib cartilage gets recommended. It's also frequently recommended in revisions.

Among those, one question comes up often in consultations. "I had two-jaw surgery — can the septum not be used?" This article organizes how materials are judged in rhinoplasty for people with a two-jaw surgery history.

Why is the septum hard to use after two-jaw surgery?

When two-jaw surgery is performed, the lower part of the septum gets cut. But using the septum for rhinoplasty requires a certain size. The remaining septum often falls short in size, so rib cartilage ends up used considering the functional aspect and safety — because at positions needing support, using firmer cartilage is more stable.

Nor is it a matter of size alone. Having gone through a major surgery like two-jaw, there's also a high possibility the interior has weakened. So for people with a two-jaw surgery history, rib cartilage is often recommended.

How is septal state checked?

Septal state is hard to confirm by external appearance. So after confirming the remaining septum's size and state through a CT scan, the material is judged.

Material	When it's considered
Septal·ear cartilage	The preferentially recommended material if size and strength suffice
Rib cartilage	When septal size is lacking or too soft; revisions; two-jaw surgery history

If rhinoplasty is done with ear cartilage alone, there's a possibility it returns to the original state or the expected height doesn't come out because it's weak. So in situations where support matters, a firmer material like autologous rib cartilage is considered. Per-material features can be viewed together in the rhinoplasty materials guide.

What else is checked in rhinoplasty after two-jaw surgery?

After two-jaw surgery, nose deformation can occasionally occur — and at that point not only cosmetic problems but functional problems can accompany.

So in rhinoplasty with a two-jaw history, the following are viewed together.

Grasping structural limits of the nose — first checking what state the remaining septum and internal structure are in.
Simultaneous cosmetic·functional resolution — handling functional problems together with shape correction matters.
A plan considering prior·later surgeries — direction is set reflecting overall facial balance and surgical history.

Rhinoplasty after two-jaw surgery is an area needing know-how accumulated from such judgments — so accurately sharing your history and building a plan matters.

Summary — surgical history changes the material

Rhinoplasty material differs not just by nose state but by surgical history too. If you've had two-jaw surgery, the septum's lower part is cut so size is often lacking — and since the interior may have weakened, rib cartilage is considered. Septal state can't be known from outside so it's confirmed by CT, and a plan viewing cosmetic and functional issues together is needed.

If you're considering rhinoplasty with a two-jaw surgery history, please have your surgical history and nose state checked together in a 1:1 video consultation.

Frequently asked questions

Answers to common questions patients ask before a consultation.

If I've had two-jaw surgery, can the septum never be used?

Rather than settling it uniformly, judgment comes after confirming the remaining septum's size and state by CT scan. However, because the septum's lower part gets cut during two-jaw surgery, the size needed for rhinoplasty is often lacking — so rib cartilage is used in many cases.

Can't ear cartilage substitute?

With ear cartilage alone there's a possibility it returns to the original state or the expected height doesn't come out because it's weak. Considering even the possibility the interior weakened after a major surgery, a firmer cartilage is more stable at positions where support matters.

My nose shape seems changed after two-jaw surgery — is cosmetic correction alone enough?

In nose deformation after two-jaw surgery, not only cosmetic but functional problems can accompany. It's important to grasp the nose's structural limits and set a plan toward resolving both together.

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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