Have Questions? Call: (212) 628-6464 or
Get an assessment now

Rib Grafts for Nasal Augmentation and Reconstruction

Harvesting Rib Graft for Dorsal Augmentation and Nasal Reconstruction

Harvesting rib cartilage for African-American and Ethnic Rhinoplasty for reconstructive and/or augmentation, is one option available to Plastic Surgeons. In my opinion, there are better alternatives to rib cartilage for dorsal augmentation; however, when no other option is available, for various reasons, rib cartilage can be a good source of usable cartilage.

Rib Graft Harvesting Surgery

Rib cartilage is typically harvested from the confluence of the seventh to tenth rib. Straight segments of the cartilaginous portion of a rib should be used to allow sufficient cartilage to fabricate all grafts. The incision is made over the skin overlying the eighth rib the soft tissue is dissected using a needle tip cautery down to the perichondrium overlying the cartilaginous rib harvest site. It is important to palpate the underlying ribs to ensure that the dissection proceeds directly over the longitudinal axis of the chosen rib. A longitudinal incision is made through the perichondrium along the length of the central axis of the rib cartilage.

Rib Grafts for Dorsal Augmentation

Once the perichondrium is incised the cartilage exposed, a perichondrial elevator is then used to elevate perichondrial flaps based on the superior and inferior borders of the rib cartilage. The dissection is then continued subperichondrial, until the posterior aspect of the rib is exposed. The final step involves separating the cartilaginous rib from its attachments near the sternum and the bony rib.

The wound should be closed in layers including perichondrium, deep and superficial fascia. If at any point during the surgery, the surgeon suspects that the pleural cavity (lung cavity) has been violated, and then procedures to diagnose and treat a pneumothorax (air entering the lung cavity) should be undertaken.

Grafts

Grafts for Septorhinoplasty can be obtained from different homologous tissues or from alloplastic materials. Homologous grafts (patient's own tissue) include septum, auricular concha and rib. The most common alloplastic materials include silicone implants, Gore-Tex and Medpor.

Disadvantages of Rib Cartilage Grafts vs. Silicone Implants for Dorsal Nasal Augmentation

Rib cartilage has several disadvantages. First, an additional incision at a distant donor site is required to harvest the cartilage. Complications can include postoperative pain, the risk of pneumothorax (life threatening air in the lung cavity), and the potential of rib cartilage to warp. If the surgeon does not harvest enough of the rib, the graft size will be not adequate, and the surgeon will not have enough material to address reconstructive or cosmetic issues for the patient. Rib grafts (or any graft) not placed in the proper tissue plane with adequate securing can show irregularities through the skin, become infected and extrude.

In Revision Rhinoplasty, removal of rib cartilage grafts can be difficult because surrounding tissue has grown into the graft and removal of rib grafts will include removal of normal tissue, which can cause visual as well as functional nasal abnormalities.

Ethic Nasal Implant

In contrast, custom carved silicone grafts, when placed and secured in the right tissue plane, will look natural and last a lifetime. Although, there is a small risk, of silicone implant infection or extrusion, they can be easily removed as the body forms a smooth capsule around the implant. Silicone implants are the most common implant to be used for breast, cheek, jaw, and chin.

Consider the amount of silicone breast implants used every year worldwide. If silicone implants were the problem, many more patients would have extrusion and infection. In my opinion, dorsal augmentation with silicone implants, placed in the right tissue plane and secured properly are superior to rib cartilage dorsal augmentation.

 
REQUEST
A CONSULTATION
Thank you for contacting us.
Some required fields are empty
Error Verification Code. Please retype
Please enter correct email address
8 + 9 =
SUBMIT

You can contact Dr. Slupchynskyj's patient coordinator and they can answer additional detailed questions, schedule a consultation, or schedule surgery.

Request Information

Happy Clients


  • I am so thankful to have come across Dr. Oleh Slupchynskyj of The Aesthetic Institute of New York & New Jersey. "Dr. S." (as I like to call him for obvious reasons, haha) is a Double Board Certified Facial Plastic Surgeon, and it turns out he has an entire website dedicated to his work with African-American patients: www.africanamericanrhinoplasty.com. I was immediately impressed with the wealth of information that he has on his site, including information about his practice, his stellar credentials, his surgical inventions (i.e., the SLUPimpla...

  • I was terrified of having surgery but after two consultations with Dr. S., my anxiety was alleviated, and this was my biggest hurdle. I was able to see what my results would be after surgery through "computer imaging". He spent as much time with me as needed and said I could come back as many times as I wanted before making a decision. That was refreshing. I asked to speak with at least 3 other patients of Dr. S. and did. They shared my initial fear and they helped me by explaining their experiences from a patient's point of view! Dr. S. specia...

  • The doctor is very approachable and personable and I felt that he is really listening to me. He made every effort to be easily accessible via email or phone. He also followed me every step of the process, not only during the surgery but also during the recovery period.

  • Double Board Certified with specialized training and loads of experience in Nose Surgery. I was able to see and discuss my results beforehand thru computer imaging so I felt very comfortable with what my result would be. Having consulted with other Drs. who did not have same training, imaging and were twice the surgical cost, I made my decision.

  • Dr. S. is excellent. From the first visit to the follow-ups I always felt comfortable. Look great and feel great, have recommended him others. Really great bedside manner and I was not the best patient. Thanks Dr. S. I really appreciate your patience!!

  • I had a Rhinoplasty done by Dr. S. and he did exactly what I wanted, which was a custom bridge implant.

  • As a 74 year old African-American woman, I was apprehensive regarding the SLUPlift™ Surgery. In the past, when I discussed plastic surgery with family and friends they spoke negatively about the surgery. Eventually I decided it was something I wanted to do for myself. I found Dr. Slupchynskyj while surfing the Internet and reviewing several of his before and after photos. After meeting the Dr. he assured me that I would be OK — and he was correct. After the surgery I did not have to take any pain medication and I was out shopping within 4 d...
  • Worth It
    I am a 27 year old, African-American female from the Midwest and I just recently had a Rhinoplasty procedure performed on February 9, 2012. I had known for a long time that I wanted to have the procedure done to correct a bump in the bridge of my nose, reduce the width of my nose, as well as to refine my down-turned nasal tip. This was an operation that I was not going to trust to just anybody, so I spent countless hours researching and looking for a surgeon who had significant experience working with African-American patients. Because I liv...
Read all »