The rib graft procedure (also known as a costal cartilage graft or rib harvest) is one of several possible surgical methods used to reshape and reconstruct a nose during a rhinoplasty surgery by the Philadelphia area's Timothy M. Greco, M.D., F.A.C.S. Patients opting for revision nose surgery especially tend to have issues that require correction best accomplished with their own rib cartilage graft.
As a facial plastic surgeon who performs both cosmetic and reconstructive surgery, Dr. Greco often performs rib graft rhinoplasty at his practice, where he is able to enhance both the form and the function of each patient's nose, and tailor every procedure to obtain the best possible results.
Often, patients visit Dr. Greco to receive a revision rhinoplasty (also known as a secondary rhinoplasty). Certain types of nasal correction—especially those required after a rhinoplasty that yields less-than-desirable results—require augmentation, reshaping, or even complete reconstruction of the nose due to problems such as functional breathing issues, asymmetry, deviation or crookedness, collapsed areas, hanging columella, saddle deformity, pinched tip, and more.
Most revision rhinoplasties are performed using an "open" approach, which is often more technically complex as the support structures in the nose have been either deformed or removed during the initial rhinoplasty. For this reason, it may be necessary to reconstruct this nasal support structure using cartilage grafts.
While a cartilage graft can be obtained from the nasal septum, there often isn't enough of the material available in that region to harvest and use as grafting material. In these cases, Dr. Greco chooses to harvest cartilage from other parts of the body.
A rib graft may be most suitable for several reasons:
The harvest procedure for a rib graft typically takes one hour. An approximately one inch-long incision is placed on the chest for access and extraction. After the harvest, the incision is closed with buried sutures and covered with tape, so minimal wound care may be required on the patient's part. The resultant scarring is small, and usually heals well. In female patients, the rib graft incision can be hidden inside the fold under the breast.
After a rib graft operation, the chest will feel sore for some weeks, and patients often say it feels like they have been through a strenuous workout. Chest exercises should be avoided for a few weeks after the surgery.
As for the nose itself, most of the swelling involved after surgery resolves in about two weeks, with the remaining swelling resolving in a matter of months. Learn more specific information about nose surgery on the page dedicated to that procedure.