Upturned-nose correction after two-jaw surgery — what compensates when septal cartilage is lacking

01

What role does septal cartilage play, and what's the problem if much is used?

Septal cartilage plays the pillar role at the nose's center. Structures propping the tip and setting direction often lean on it — so it's viewed as especially important in states where the central structure has already changed, like post-two-jaw rhinoplasty.

So harvesting this cartilage excessively risks weakening tip support — the tip sinking or the shape deforming. That's why overharvesting is avoided in rhinoplasty. Use what's needed while keeping the remaining amount from falling short, and supplement the lacking part with other cartilage.

In other words, the answer to "what happens if all the septal cartilage is used" is closer to: the plan is made in a direction that doesn't use it all.

02

Is using ear cartilage together when the septum is lacking okay?

Using ear cartilage together as an auxiliary material is a method generally performed in upturned-nose surgery or post-two-jaw rhinoplasty. A considerable share of cases lacking septal cartilage choose this approach.

Since harvesting proceeds within a range that doesn't affect ear shape, the fact of using ear cartilage itself needn't be viewed as a problem. Still, ear cartilage is on the soft side, so suitable and unsuitable cases divide by how much support is needed — and that judgment is made by viewing the current nose state.

03

When is donor rib cartilage considered?

Donor rib cartilage also has pros and cons.

Having cons doesn't mean it's a bad material. In states where the needed support amount is large — like weakened septal support — donor rib cartilage can become an alternative.

In conclusion, it's hard to conclude which material is better. Deciding after checking all of the current nose shape, degree of lift, septal support, and overall structure is most accurate. Each material's characteristics can be seen in more detail in the rhinoplasty materials guide.

04

How is this judgment reflected in actual upturned-nose correction?

This was a case where the nose was short enough that nostrils showed a lot frontally, and the tip was lifted in profile. The bridge itself was relatively high, but there was a history of past filler treatment. The surgical plan was set in this order.

• Filler removal (dissolving) — structural correction starts after the existing filler is first organized.
• Bridge organization — wanting a natural line without an excessive feel, 4mm silicone was used.
• Lacking cartilage reinforcement — ear cartilage was used together since septal cartilage alone wasn't sufficient in amount.
• Hump organization — the small, fine hump at the dorsum's center was trimmed softly.
• Tip length secured — the short tip's structure was set by securing length via a method of stacking multiple layers of cartilage.

After surgery, as the tip came down to a natural angle, the balance of tip length and the overall line was organized — and in the view from below, changes in tip width and nostril shape were confirmed together.

The part where nostril size looks slightly different frontally is a feature commonly appearing with septal deviation. Making complete left-right symmetry is difficult, but the goal is reducing how much it stands out to a level that's not inconvenient in daily life. The width of such change can be checked in before-and-after photos.

05

Summary — what comes before material is the current structure

In upturned-nose correction after two-jaw surgery, the material discussion naturally comes first — but the actual order is closer to the opposite. Only after checking how lifted the nose is, how far the tip must come down, and how much support is needed to hold that — is it decided whether septal cartilage suffices, ear cartilage is added, or donor rib cartilage is considered.

If you're curious whether your remaining septal cartilage is sufficient, it can be checked directly in a 1:1 video-call consultation.