Gregory Dibelius  0:00 

Hey everyone, today I wanted to address a question that I sort of commonly get, which I think is a really interesting one.

Gregory Dibelius  0:06  

We talk a lot about doing rib graft reconstructions of a nose during a revision rhinoplasty, and I’ve heard the question, won’t that make my nose bigger over a few times?   

I think that’s really interesting because it sort of is logical that if you put a large piece of cartilage into the nose it’s going to enlarge it, but in fact, it’s all about how it’s used. So we frequently use a rib graft to actually make a nose directly smaller and that’s part of our goal for the revision.

Gregory Dibelius  0:33

It’s just about how the rib is used. I view it as just a raw material. We harvest a sort of a block of it from the chest and it’s just a piece of raw material that has endless possibilities and it’s our job to make sure that we use it correctly.

Gregory Dibelius  0:48 

I would say from a novice sort of rib graft surgeon, when they start out, the tendency is to leave a little bit of extra size on the grafts and I think that’s where experience comes in.  You have to make them very narrow.  You have to spend the time to really carve them to the precise thickness that’s needed, but when you do that you can achieve incredible things.

Gregory Dibelius  1:10

You can narrow the nose while providing structure at the same time, while providing support, while improving breathing, and improving the appearance of the nose at the same time.