In their enthusiasm to re-contour their noses, many patients overlook the possible risks and long-term complications associated with this particular facial surgery.A new report released by JAMA Facial Plastic Surgery shares illuminating research from South Korea that points to the long-term benefits of rib cartilage rhinoplasty.
JeeHye Wee, M.D., of the National Medical Centre in Seoul, was lead author in a study that looked at all available data toassess complication rates associated with autologous rib cartilage and rhinoplasty. There’s good news to be learned, and some work yet to be done.
Why Not Use Cartilage from the Nose in Rhinoplasty?
In some instances, there is not enough septal (nose) cartilage to provide structural support or proper contour in rhinoplasty. When that happens, surgeons look to other parts of the body, including the ribs. Costal cartilage, found at the anterior ends of the ribs, is a good material, but the harvesting process can be dangerous.
The major risk when harvesting costal cartilage is a pneumothorax. If the graft is performed badly, air escapes from the lung into the chest cavity. When that occurs, it causes the lung to collapse.
Another alternative is a synthetic nasalimplant shaped by the facial plastic surgeon to be the exact size and shape required for the patient’s nose.Despite their cosmetic appeal, however, synthetic implants can cause infection, move, or even be rejected by the patient’s body.
Research Gives Thumbs Up to Rib Cartilage for Rhinplasty
Researchers found that using strong, abundant cartilage from the patient’s rib cage results in low rates of overall long-term complications, including problems at the rib site where the cartilage is harvested.Among the complications studied:
- Pneumothorax – 0.0 %
- Resorption – .22%
- Displacement – .39%
- Infection – .56%
- Revision surgery – 14.07%
The use of autologous rib cartilage may not be appropriate for dorsal augmentation to build up the bridge of the nose, where it carries a 3.08% rate of warping. Rib cartilage rhinoplasty also has a 5.45% rate for hypertrophic chest scarring (keloids). Authors of the study suggest that surgeons’ skill can help to reduce these complications.
More and Ongoing Studies Needed
Data for the study was gathered from ten other studies where a total of 491 rib cartilage rhinoplasty patients were observed. The follow-up period lasted as long as 33 months. Though the data is compelling, the study’s authors conclude that additional research is needed with larger sample groups and a follow-up of greater duration.