Open Structural Rib Rhinoplasty (Rib Cartilage 100%) is an open rhinoplasty procedure that uses the patient's own rib cartilage (Autologous Rib Cartilage / Costal Cartilage) as the primary material for reshaping the nasal dorsum, refining the nasal tip, and reconstructing supporting structures, without using a silicone implant for dorsal augmentation.
This approach differs from Open Hybrid Structural Rib Rhinoplasty, which combines medical grade silicone for the nasal dorsum with rib cartilage for the tip and supporting structures. With Rib Cartilage 100%, the surgeon shapes the patient's own rib cartilage for different anatomical functions, from the dorsum and nasal tip to structural support, according to individual anatomy and surgical requirements.
At Dr. Gorn Aesthetique, surgical planning considers the existing nasal structure, skin thickness, facial proportions, cartilage quality, and previous surgical history to determine the appropriate use of rib cartilage.
What Is Open Structural Rib Rhinoplasty?
This technique combines three key principles:
- Open Rhinoplasty – Provides direct access to the internal nasal structures, allowing the surgeon to visualize and adjust the anatomy.
- Structural Rhinoplasty – Modifies or reconstructs the nasal support system according to the planned nasal shape.
- Autologous Rib Cartilage – Uses the patient's own rib cartilage as the primary material for reshaping the nasal dorsum, refining the tip, and building supporting structures.
Rather than focusing solely on increasing nasal height, this approach considers the relationship between all nasal structures, from the base and dorsum to the nasal tip.
What Does Rib Cartilage 100% Mean?
For this procedure, Rib Cartilage 100% means using the patient's own rib cartilage as the primary material for nasal augmentation and structural shaping, without using a silicone implant for the nasal dorsum.
The surgeon may shape rib cartilage for different purposes, including:
- Building or increasing nasal bridge height
- Adjusting the alignment and shape of the nasal dorsum
- Constructing nasal tip support
- Adjusting tip projection
- Adjusting nasal length and angles when indicated
- Reconstructing nasal structures in revision rhinoplasty
The shape and amount of cartilage required vary according to each patient's anatomy.
Why Choose 100% Rib Cartilage for Rhinoplasty?
One important consideration is that rib cartilage can provide a relatively large amount of cartilage, which can be shaped into different grafts for various structural functions within the nose.
The surgeon may consider a Rib Cartilage 100% approach when there is a need to:
- Avoid using a silicone implant for nasal bridge augmentation
- Use the patient's own tissue as the primary grafting material
- Obtain a relatively large amount of cartilage
- Reconstruct both the nasal dorsum and tip support structures
- Address insufficient or weakened existing nasal structures
- Address an insufficient supply of septal cartilage
- Reconstruct nasal structures after multiple previous rhinoplasty procedures
However, using 100% rib cartilage does not mean that this technique is superior to other approaches for every patient. Material selection should be based on individual indications and treatment goals.
How Is Rib Cartilage Used to Build the Nasal Bridge?
When rib cartilage is used instead of a silicone implant for dorsal augmentation, the surgeon prepares and shapes the cartilage according to the desired height, width, and contour of the nasal bridge.
Dorsal design considers factors such as:
- Existing nasal bone foundation
- Nasal bridge width
- Skin thickness
- Nasal radix position
- Nasal alignment and symmetry
- Continuity between the dorsum and nasal tip
- The relationship between the forehead, nose, lips, and chin
The goal is to create a dorsal profile that complements the face, rather than simply maximizing nasal bridge height.
Using Rib Cartilage for Nasal Tip Reconstruction
For the nasal tip, rib cartilage may be used as part of the structural support system to help determine tip position, shape, projection, and rotation.
Because nasal tip support must function together with the existing cartilage and surrounding tissues, the surgeon must establish appropriate structural strength without creating excessive tension on the nasal tip skin.
Using more cartilage does not necessarily produce better results. The amount and placement must be appropriate for the patient's anatomy.
How Is Open Structural Rib Rhinoplasty Different from Open Hybrid Rib Rhinoplasty?
The main difference lies in the material used for the nasal dorsum.
Open Hybrid Structural Rib Rhinoplasty uses medical grade silicone for the nasal dorsum and rib cartilage for the nasal tip and supporting structures.
Open Structural Rib Rhinoplasty – Rib Cartilage 100% uses autologous rib cartilage as the primary material for the dorsum, tip, and structural support, without a silicone implant for dorsal augmentation.
The appropriate approach depends on individual anatomy, available cartilage, patient preferences, and the surgeon's assessment.
Who May Be Suitable for Rib Cartilage 100% Rhinoplasty?
Individuals with the following characteristics may consider a surgical assessment:
- A desire to undergo rhinoplasty without a silicone implant for the nasal dorsum
- A preference for using their own cartilage as the primary grafting material
- A need to modify both the nasal dorsum and tip
- A need for extensive nasal structural reconstruction
- Insufficient existing nasal support
- Insufficient septal cartilage
- Septal cartilage previously harvested during earlier surgery
- A history of multiple rhinoplasty procedures
- Nasal contracture or structural changes following previous surgery
- A need for revision rhinoplasty involving structural reconstruction
Is Rib Cartilage 100% Suitable for Revision Rhinoplasty?
In some revision rhinoplasty cases, previous surgery may have altered the original nasal structures, resulting in scar tissue, removed cartilage, or insufficient structural support.
Rib cartilage can provide an additional source of cartilage for rebuilding the nasal dorsum and supporting structures, particularly when septal or ear cartilage is insufficient for the planned reconstruction.
However, revision rhinoplasty varies in complexity. The surgeon must assess the skin, scar tissue, existing anatomical structures, and previously used materials before selecting the appropriate approach.
Advantages of Using Autologous Rib Cartilage
Potential advantages and considerations of autologous rib cartilage include:
- It is tissue obtained from the patient's own body
- It can provide a relatively large amount of cartilage
- It can be shaped into various structural grafts
- It may be used to reconstruct both the dorsum and tip when indicated
- It may be suitable when additional structural support is required
- It offers an alternative for patients who prefer not to use a silicone implant for the nasal bridge
- It can be used in certain types of revision rhinoplasty
However, cartilage harvested from the patient's own body can still undergo changes after surgery and should not be considered a risk-free material.
Can Rib Cartilage Warp or Change Shape?
Rib cartilage may undergo warping, or bending and changes in shape, after it has been harvested and carved.
The surgeon must therefore carefully consider the harvesting technique, cartilage section selected, carving method, and graft preparation before implantation.
Other changes may also occur, including partial resorption, asymmetry, or alterations in nasal shape over time.
Will Rib Cartilage 100% Rhinoplasty Look Natural?
A natural-looking result does not depend solely on the grafting material. It also depends on facial proportions, dorsal height, nasal tip projection, skin thickness, and the relationship between the nose and surrounding facial features.
Even when rib cartilage is used throughout the reconstruction, an excessively high nasal bridge or excessive tip projection beyond the limitations of the surrounding tissues may result in proportions that do not complement the patient's anatomy.
Personalized Structural Rhinoplasty therefore emphasizes designing nasal contours according to each individual's anatomy rather than selecting a material alone.
Where Are the Incisions for Open Structural Rib Rhinoplasty?
The procedure generally involves incisions in two areas.
Nasal Area – Incisions are made inside the nostrils together with a small incision across the columella to access the internal nasal structures.
Rib Area – An incision is required to harvest autologous rib cartilage. The incision location and length depend on individual anatomy, the amount of cartilage needed, and the surgical technique.
Patients should therefore receive information about wound care and the potential risks associated with both surgical sites before the procedure.
How Long Is Recovery After Open Structural Rib Rhinoplasty?
Because surgery involves both the nose and the rib cartilage donor site, patients may experience temporary swelling, bruising, tightness, nasal congestion, and discomfort at the cartilage harvesting site during the initial recovery period.
The nasal shape gradually changes as swelling subsides. The nasal tip, in particular, may take longer than other areas to settle into its final appearance.
Recovery time varies according to the extent of surgery, individual anatomy, and the healing process.
