In rhinoplasty, a cartilage graft also known as “moldable tissue” is a procedure done to correct the structure of the nose or enhance its aesthetic appearance.
Cartilage grafts are used during rhinoplasty both to improve the aesthetic appearance of the nose and to enhance its functionality.
In this procedure, cartilage tissue taken from the patient’s own body (usually from areas like the ear, rib, or nasal septum) is transferred to areas of the nose that need support or reshaping.
What is Cartilage?
Cartilage is a type of flexible and sturdy tissue in the body. It is found in joints, ears, and the nose, where it protects and supports bones. Its soft structure facilitates movement and protects against impacts.
Different Types of Cartilage Grafts
There are different parts of the body where cartilage grafts can be taken.
Septal Cartilage Graft
A septal cartilage graft is made with cartilage tissue taken from the patient’s nasal septum. It is commonly used in rhinoplasty to support and shape the structure of the nose.
Ear Cartilage Graft
An ear cartilage graft is performed using cartilage taken from the patient’s ear. Typically thinner and more flexible, it is preferred for reshaping the tip of the nose.
Rib Cartilage Graft
Used especially in rhinoplasty when significant structural changes are required, this type of graft is preferred when a large amount of cartilage material is needed to support and reshape the nose structure. In nose reshaping surgeries, the robustness of rib cartilage is ideal for reconstructing large areas, such as the nasal dorsum.
In nose job, synthetic grafts are also used, one of which is made from Gore-Tex. Gore-Tex is a durable and biocompatible material. These types of grafts are particularly used in cases where the patient’s cartilage tissue is insufficient. Gore-Tex grafts are usually preferred for elevating and shaping the nasal dorsum. Although artificial, they are generally well tolerated by the body and provide long-lasting, stable results.
The type of graft commonly preferred in rhinoplasty surgeries is the septal cartilage. As it is harvested from the patient’s nasal septum, it has high biocompatibility and a low risk of being rejected by the body. Additionally, it possesses a flexible structure that can adapt to various rhinoplasty techniques and typically allows for the achievement of natural-looking results.
When is Cartilage Graft Necessary in Nose Job?
Cartilage grafts are used to make certain corrections or enhancements without requiring major surgery and are tailored for more specific needs. Some of these include:
- Elevating the Nasal Dorsum: Cartilage grafts are used for elevating or straightening the nasal dorsum.
- Tip Refinements: Cartilage grafts are utilized to achieve a more rounded or upturned appearance of the nasal tip.
- Nostril Reshaping: Grafts are preferred when reshaping of the nostrils is needed.
- Breathing Problems: If the nasal septum is deviated or there are narrowings, grafts can help improve breathing.
- Structural Support: Grafts are chosen when the nasal structure needs to be supported or strengthened.
Graft or Non-Graft Rhinoplasty
Graft rhinoplasty is a method where cartilage or tissue grafts are used to support or reshape the nasal structure. Non-graft rhinoplasty, on the other hand, works solely on the existing nasal structure without the use of grafts. The choice of method depends on the patient’s needs and the goals of the rhinoplasty.
Who is the Ideal Candidate?
Cartilage grafting is suitable for individuals seeking improvements or corrections in their nasal structure. For instance:
- Patients needing correction or elevation of the nasal dorsum.
- Those who desire reshaping of the nasal tip.
- Individuals considering enlargement or reduction of the nose.
- Patients requiring internal nasal corrections for breathing problems.
Furthermore, individuals with Asian nose type usually have less developed nasal bones and cartilage. Therefore, patients in this group have a favorable constitution for cartilage grafts during rhinoplasty to improve their nasal structure.
Advantages and Disadvantages of Cartilage Graft in Rhinoplasty
While cartilage grafts in rhinoplasty surgery can improve outcomes, they come with advantages and disadvantages. Here are some of them;
- Natural Results: Results achieved using cartilage grafts can enhance the aesthetics of the nose more naturally and harmoniously, better integrating with the patient’s face.
- Structural Support: Grafts can be used to support or correct the nasal structure. This can improve the functionality of the nose and help alleviate breathing problems.
- Customizability: The type and placement of cartilage grafts can be adjusted according to the specific needs and desires of the patient. This offers a more personalized treatment approach.
- Additional Surgery: Additional surgical sites may be needed to harvest grafts, which can extend the duration of the surgery.
- Rejection Risk: The body may sometimes reject grafts, though this risk is lower when the patient’s tissue is used.
- Prolonged Healing Process: Swelling and bruising in the areas where grafts are placed may last longer.
There are some potential complications associated with the use of cartilage grafts in nose job surgeries that need to be considered.
- Graft Resorption: This refers to the situation where tissue grafts are absorbed and diminished over time by the body. It applies to tissue grafts that the body perceives as foreign and gradually absorbs over time. Surgeons are required to use appropriate graft choices and placement techniques to minimize graft resorption.
- Shape and Stability Disturbances: Shape deformities such as collapse in the nasal dorsum, drooping of the nasal tip, or loss of nasal symmetry are problems that can arise after rhinoplasty. Stability disturbances include problems arising from a lack of support in the nasal structure, leading to deformation over time or loss of functionality.
Cartilage Graft Nose Healing Process
The healing process in nose surgeries using cartilage grafts typically varies depending on the area from which the graft is taken and the unique condition of the nasal structure. Swelling, bruising, and mild pain in the nose and the area where the graft is taken are normal.
How long does it take for Cartilage Grafts to heal?
Complete healing of cartilage grafts usually varies from a few weeks to a few months. This duration varies based on the area from which the graft is taken, the surgical technique used the patient’s overall health, and how well the patient’s body accepts the graft.
FAQ About Cartilage Graft Rhinoplasty
Patients do not feel pain during the procedure as they are under anesthesia. Post-operatively, mild to moderate pain and discomfort can be experienced. These pains are managed with pain relievers recommended by the doctor.
The results are generally permanent. However, the success of the graft settling and the permanence of the results can vary depending on the patient’s overall health, skin structure, and post-surgical care.
The most commonly preferred type of graft is one taken from the patient’s own body, with the ideal option being the septal cartilage from inside the nose. This is because its tissue structure is suitable for the nose and is easily accepted by the body.
Yes, rhinoplasty using ear cartilage provides permanent results. This is because ear cartilage has sufficient flexibility, is well accepted by the body, and carries a very low risk of allergic reactions.