Q: I’ve already had the back of my ear used for one failed rhinoplasty. I need to get it right this time. I need dorsal augmentation, tip support, definition & slight rotation/projection. I feel building up my bridge w/anything more rigid will make me look masculine (I am female & want a short but straight nose). Where can the ear be mined for tip-suitable cartilage?
A: With cartilage from your septum and one ear already exhausted, it is unlikely the other ear will provide enough cartilage to provide dorsal augmentation, tip support, and counter-rotation + projection. Rib cartilage provides a large volume of strong, straight cartilage for structural grafts (extended spreader grafts, septal extension graft) for tip projection/counter-rotation.
For dorsal augmentation, I feel the diced cartilage fascia (DCF) technique is the best option as it provides the most natural looking and attractive contours in a permanent fashion.
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