Carolina Facial Plastic Surgery

Cartilage Harvest

Nasal cartilage grafting is an essential tool in most primary and revision rhinoplasties to ensure the nose will not collapse years after the surgery.  The nose has to be supported and have a solid foundation to ensure it will last a lifetime.   Cartilage can be taken from the septum, ear or rib which is placed in the nose. The cartilage is used for a variety of reasons to change the shape, increase the support, and open the airway of the nose. Cartilage grafting is an essential method to achieve the best aesthetic and functional results during a procedure.

Why Choose Dr. Kulbersh for Your Rhinoplasty Surgery?

A rhinoplasty is one of the most complex plastic surgery procedures.  Dr. Kulbersh has had extensive training and experience performing these procedures.  As a facial plastic surgeon, his sole focus is on plastic surgery of the face.  He was trained by two of the most prominent plastic surgeons in Beverly Hills, Dr. Paul Nassif and Dr. Babak Azizzadeh, and he has been involved in 100’s ofprocedures.  At Carolina Facial Plastics in Charlotte, rhinoplasty is the most common surgical procedure performed at the practice.  Dr. Kulbersh has a passion for rhinoplasty procedures and has the skills and knowledge to perform the most complicated cases.

Where Is Cartilage Taken From?

Revision-Rhino-2There are  3 common areas where the cartilage is harvested–the septum, ear, and rib.  Each location is different by the amount, shape and size of the available cartilage. During your consultation at Carolina Facial Plastics  in Charlotte, Dr. Kulbersh will  be able to address the issues you’re seeking to correct and determine which area will be the best site for nasal cartilage harvesting.

Nasal Septum (Septal) Cartilage

The nasal septum is composed of both cartilage and bone and separates the right and left nasal passageways.  It helps support the nose, but there is a surplus of cartilage in the area.  A portion of this cartilage can be removed without weakening the support of the nose.  For this reason, the cartilage is frequently harvested and used during a rhinoplasty.  There are no long-term issues by removing the excess cartilage in the nasal septum.  From a surgeon’s perspective, this cartilage has the advantage of being straight and strong, which are two  important characteristics for cartilage during nasal cartilage grafting.

Ear (Conchal) Cartilage

The entire ear is composed of cartilage, but it is not all necessary.  The “bowl” of the ear or middle part of the ear is not functionally important.   It can be removed without changing the appearance of the ear.  When Dr. Kulbersh uses ear cartilage, the incisions are located behind the ear to hide the incision.  The ear cartilage is not as strong or straight as the septal or ear cartilage, but can be very useful during a procedure.  If the new nasal cartilage needs to be made straighter, Dr. Kulbersh will attach it to a restorable PDS plate.

Rib (Costal) Cartilage

The ribs are composed of both cartilage and bone.  The rib can supply an abundant amount of both strong and straight cartilage.  A small segment of the rib cartilage can be removed without any long term consequences.  The incision to remove the rib cartilage is 2-4 cm in length.  Rib cartilage harvesting is reserved for patients that are going to require extensive cartilage grafting or do not have septal or ear cartilage available secondary to a previous surgery.   If rib cartilage needs to be used for your procedure, it is important that an experienced facial plastic surgeon performs this procedure.  The downside to using rib cartilage is that it can be painful after surgery.  Carolina Facial Plastics ensures that  patients have the proper pain medications to ensure they are as comfortable as possible.

Cartilage Harvesting FAQs

Q: What is cartilage?

A: Cartilage is a flexible, but strong form of tissue that is found in various parts of your body, including the nose, ear, ribs, and joints. When Dr. Kulbersh performs a rhinoplasty or revision surgery , he uses cartilage grafting to build a structurally appropriate nose. Using additional nasal cartilage during a procedure ensures that the nose is functionally sound and has the necessary strength to work properly for years after the surgery.

Q: Do I need cartilage grafting for my revision rhinoplasty?

A: Many patients wonder whether cartilage grafting is necessary in revision. Because each patient is different, the answer depends on the characteristics of the nose, its size, structure, support, and appearance.  I would say approximately 85% of revision procedures will need cartilage grafting.   Cartilage grafting during a revision is safe and Dr. Kulbersh uses the least invasive method possible, limiting the amount of additional downtime.

Q: If a graft is needed, where will it be harvested?

A: If a cartilage graft is necessary, the ear and septal regions will be the first candidates for harvesting. In the event these cartilages has been previously used or the patient requires extensive amount of cartilage grafting, rib cartilage will be used. It is dependent on a case by case basis.  During your  consultation, Dr. Kulbersh will be able to determine the best options for nasal cartilage harvesting.

Q: What are the advantages of cartilage harvesting?

A: The alternative to using cartilage grafts is synthetic implants. Implants have the risk of the body rejecting it or an infection (that may occur many years after the surgery).  The most apparent advantage of using a cartilage graft is that it is natural tissue from your body.  It eliminates the risks of bodily rejection or an implant infection.  Dr. Kulbersh believes cartilage grafting is a safer method than using synthetic implants during a surgery.

If You Want to Learn More About Cartilage Harvesting

It is Dr. Kulbersh’s goal that patients are well-informed and understand their surgical process relating to revision rhinoplasty, therefore he is more than happy to provide  additional information on cartilage harvesting for procedures. If  interested in learning more about cartilage grafting for rhinoplasty and to determine a good candidate, contact Carolina Facial Plastics in Charlotte today to schedule a consultation by calling 704.323.5090.

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