Gregory Dibelius  0:00 

0:00

When we talk about rhinoplasty, one of the most important decisions isn’t just

0:04

how we shape the nose. It’s what we build it with. Specifically, cartilage.

0:08

There are four main options. The septum, which comes from the middle of your

0:12

nose, the ear, your own rib, and donor rib. The right choice depends on the

0:18

case. Septal cartilage is most commonly used in primary rhinoplasty. It’s

0:22

straight, strong, it’s made of highin cartilage, so it holds its shape well

0:26

over time and doesn’t tend to calcify. The limitation of it is the supply.

0:31

There’s only so much of it. In revision cases or when more structural support is

0:35

needed, autotogus rib cartilage or your own rib is often the better option even

0:39

if septum is still available. Now, rib is also high in cartilage. So, it’s very

0:44

strong, but it behaves differently from septum. It has internal stresses from

0:48

how it developed and when we carve it, those stresses can release, which is why

0:52

it can warp over time. It’s also more prone to calcification, especially as we

0:57

get older, which makes it technically harder to work with. But overall, it

1:01

remains the best option for complex rhinoplasty work. Donated rib cartilage

1:07

is another great option. The big advantage is obviously there’s no

1:11

additional surgery, no chest incision, and less recovery. With modern

1:15

processing techniques, studies show that low rates of infection, resorption, and

1:19

complications. So overall, it’s considered very safe and I use it

1:23

frequently in my practice in primary rhinoplasty as a backup option. And

1:28

finally, there’s ear cartilage. In my opinion, it has a very limited utility

1:32

for most structural or aesthetic goals. It’s elastic cartilage, which is

1:36

different. It’s soft. It’s curved and springy, which makes it difficult to use

1:40

when you need strong, stable support or precise shaping. At the end of the day,

1:45

the choice of cartilage is all about the case, matching the material to the

1:48

structural and aesthetic goals of the individual patient.