Another patient’s chest scar earlier postop shown at the bottom of the right breast. This scar will continue to fade with time.
Pain – some of it excessive – is also associated with rib cartilage harvest. Using our muscle preserving technique with limited dissection, most patients experience minimal post-surgical pain that is easily controlled with medication and decreases significantly within 36 hours of surgery. A recent study that we performed showed that the pain associated with costal cartilage harvest is no greater than that associated with ear cartilage harvest using our rib harvesting technique.
With costal cartilage, the grafts can warp or bend after being carved or shaped, due to the internal stresses of costal cartilage, as a result, bending needs to be controlled to prevent against deformity. Some surgeons use steel wires in cartilage grafts to avoid warping, and others dice the cartilage to avoid warping. Both techniques can have consequences. Using our technique of carving rib cartilage and selecting the proper graft has, over the last 20 years of using costal cartilage, minimized the chance of warping of grafts.
We recently refined our technique to minimize other ill effects associated with costal cartilage. To reduce the effect of a stiff, unnatural feeling nose, for example, we have refined our technique so that grafts are used in a manner that minimizes stiffness in the nose, leaving the nose feeling more natural. To control the nose’s size and width, another unwanted side effect, we use numerous intraoperative measurements of nasal length, projection, and width to help insure that the agreed upon aesthetic goals are achieved.
We have tried to take the art of costal cartilage grafting in rhinoplasty to a new level. Using our costal cartilage techniques we are able to correct severe secondary rhinoplasty, post-traumatic, and even congenital cases.