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by bergy76 » Fri, 31 Oct 2008 2:39 pm
At the end of the day, where they get the cartilage from doesn't matter. It's just the case of how much and in what shape they want the cartilage to be in. If little and flat cartilage is required, then a conchal (ear bowl) graft or a septal (nose partition) graft would suffice. If major lifting of the nose is required than a costal (rib) cartilage would be needed. Also rib cartilages by virtue of their size, can easily be reshaped and many plastic surgeons (well, the ones I know) like these.
In terms of synthetic grafts or autologous (harvested from you own body eg cartilage), there are pros and cons. As mentioned in the previous post, synthetic grafts like silicone, med-pore and gore-tex have a risk of extrusion over time which would require them to be taken off. However, synthetic grafts are easier to shape. Autologous grafts are more readily accepted by the body but if too much is used like a rib graft, there is a risk of warping (bending) over time and they are also slightly more difficult to shape.
When it comes to nose surgery, it is arguable whether a ENT surgeon or a plastic surgeon is better. ENT surgeons can harvest cartilage and even bone from the nose itself to use as grafts for rhinoplasty and they can address functional issues as well. But whether they are as good as plastics when it comes to the aesthetics is debatable.