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I am looking at a revisionrhinoplasty that may require rib grafting, and had some questions I was hoping you could help me with. Is rib the strongest grafting material, next to septum, especially for structure/support (as opposed to ear), or all they all about the same? Also, where is the rib generally taken from (which rib and from where, i.e. is it the rib directly underneath the breasts, or lower?). The reason I'm asking is because a few years ago, I (regrettably) had breast augmentation and am wondering how this will affect the procedure. Will this create problems for harvesting the rib?
Rib cartilage is good when your surgeon needs lots of cartilage and cartilage for structural support. Septum and one or both ears can be used as well and there are techniques for suturing and reinforcing ear cartilage to create strong support grafts. Newly available PDS sheets can also be used to create various shaped grafts. Frozen or irradiated cadaver rib is also a viable option.
As far as which ribs are taken depends on your surgeon's preference. Usually one or more ribs are taken: #6,7,8,9. Sometimes a full thickness section of rib is taken and other times a section is carved out of the rib almost as if making a canoe. Some surgeons take a portion of rib cartilage with rib bone attached.
Typically the incision is under your breast and your surgeon should be able to take the rib without damaging your implant but the risks of rib harvest are damage to the lung lining as well as potential damage to an implant. In good hands, it should be a minimal risk.
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