Implications of Having Weak Nasal Cartilage in Rhinoplasty

Q. Can graphs make the nose appear larger? Why do they say that having strong nasal cartilage is so much better to have?

A. Weak nasal cartilages are less likely to provide adequate support or create a defined nasal tip. In a primary Rhinoplasty, with weak cartilages, there are two basic options on how to create both increased support/symmetry as well as a more tip definition. Which one is appropriate, IMHO, depends on the angle of nasal tip rotation.

  1. The nasal cartilages can be trimmed making the tip more refined and then the cartilage can be sutured together which creates added symmetry and support.
  2. The nasal cartilages can be trimmed making the tip more defined and then cartilage graft(s), I prefer using conchal ear cartilage for tip grafts, can be placed to create added tip definition and strength. Cartilage struts can be sutured inside the Columella (crural feet) for additional tip support if required.

In Revision Rhinoplasty, much less cartilage trimming is typically called for since this was most often done during the previous Rhinoplasty. The approach then becomes one of spot adjustments to make the tip appear defined, symmetric and natural in appearance using any and all of the techniques described above.

These options should be explained in detail, by the Rhinoplasty Surgeon, during the Rhinoplasty consultation. The Rhinoplasty Surgeon must, IMO, understand and follow the proper aesthetics of facial (and nasal) beauty for the creation of a naturally more attractive nose. Experience performing Rhinoplasty alone is simply not enough because using the wrong technique will not make the nose more attractive no matter how experienced the Rhinoplasty Surgeon may be.