Rib Grafts for Rhinoplasty
All cosmetic surgery involves risks and individual results vary. Cosmetic surgery is a serious decision. Decisions about whether to proceed should be made after careful consideration and following at least two consultations with a qualified medical practitioner.
In many rhinoplasty procedures — and in almost all revision rhinoplasties — cartilage grafts are required to restore structural support or shape in the nose. The preferred source of cartilage is the nasal septum, but where septal cartilage is unavailable (often depleted in previous surgery) the rib is a common and important alternative source.
All surgery carries risks — read the full rhinoplasty risks page →
Why a Rib Graft May Be Needed
The first preference for rhinoplasty cartilage grafts is the nasal septum — the straight, strong cartilage inside the nose. In patients who have had previous septal surgery, the available septal cartilage may be insufficient or absent. In these cases, Dr Roth will assess whether ear cartilage or rib cartilage is more appropriate for the specific requirements of the procedure.
Rib cartilage is often chosen over ear cartilage where structural strength and volume of graft material are required — it provides more cartilage and tends to be stronger. The tradeoffs of rib cartilage (a tendency to warp after carving, a separate harvest site, and a longer integration time) are weighed against those requirements at the planning stage.
Which Rib Is Used?
Dr Roth commonly harvests from the fifth or sixth rib. The fifth rib tends to be straighter but provides less volume; the sixth rib offers more cartilage but with greater curvature. The choice depends on how much cartilage is needed and how it will be used in the rhinoplasty. The incision is placed in the natural crease of the chest or breast, where it is minimally visible once healed.
The Procedure
Rib graft harvest and rhinoplasty are performed together under general anaesthesia. The full procedure typically takes up to four hours. Some patients can go home the same day; others require an overnight stay. Recovery involves a period of rest from both the rhinoplasty and the rib harvest site. Most patients can return to light activities within two weeks and a full schedule within four to six weeks.
As with all rhinoplasty, swelling from the procedure takes considerable time to resolve. The nose does not reveal its final appearance until 12–24 months after surgery.
Allograft vs Own Rib Cartilage — which does Dr Roth prefer and why? →
Contact us to arrange a consultation → | Revision Rhinoplasty → | Rhinoplasty Risks →
Dr Roth’s Clinical Perspective
When rib cartilage is required for rhinoplasty, the choice between harvesting the patient’s own rib and using irradiated cadaveric rib allograft is one I discuss at every consultation where this is anticipated. My preference in most cases is irradiated cadaveric rib allograft — it avoids the chest wall pain and recovery burden of a separate harvest site, warps less predictably than fresh autologous rib, and provides a reliable volume of straight graft material. The decision is made based on the individual case, and I explain the reasoning clearly so patients understand what is being used and why.
— Dr Jason Roth, MBBS, FRACS (ORL-HNS), IBCFPRS
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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