Secondary Rhinoplasty surgeries

Why does Dr. Toriumi only use rib cartilage for secondary rhinoplasty surgeries? 

Answer by Dean Toriumi:

The short answer is that I don't only use rib cartilage for such surgeries.

I prefer to use rib cartilage for secondary rhinoplasty cases primarily because most of these noses are depleted of structure, and ear cartilage may not be adequate to do a satisfactory reconstruction. However, many patients can be corrected using ear cartilage and whatever septal cartilage is remaining. In fact, I used primarily ear cartilage for the first 15 years of my practice with good success.

Shown below is a patient who underwent successful reconstruction with ear cartilage and is now five years out from surgery. She initially presented with a deformed nasal tip (nasal tip bossae). We performed a reconstruction using ear cartilage, and she has done well over the past five years with a good aesthetic outcome. The first set of photos shows the preoperative views and the five-year postoperative views. Note how the tip deformity has been corrected. In the second set of photos one can see the degree of increase in definition that occurred from the second to the fifth year. Frontal view shows significant narrowing of the nose and nasal tip from the second to the fifth postoperative years. Lateral view shows how the supratip fullness resolved without any intervention. This illustrates how the nose continues to shrink over time.