A Surgeon’s Approach: Why Cartilage Matters in Nose Surgery

Modern rhinoplasty is far more than cosmetic enhancement—it often blends aesthetics with the restoration of nasal function. One of the foundational techniques that enables such balance is cartilage grafting. Surgeons frequently rely on this method not just for reshaping but for rebuilding nasal structures in ways that preserve long-term stability and functionality.

Dr. Kim Hyung Taek, a board-certified plastic surgeon with nearly two decades of rhinoplasty experience in Seoul, explains: "Autologous cartilage allows for a customized, biologically harmonious reconstruction. It's especially vital in complex or revision cases."

The increasing demand for nose surgeries that correct both form and function has made cartilage grafting a vital technique in the rhinoplasty surgeon’s toolkit. Whether it’s correcting a collapsed nasal bridge or reinforcing internal support to enhance breathing, cartilage offers a dynamic and safe alternative to synthetic implants.

What Is Cartilage Grafting?

Cartilage grafting involves transplanting cartilage—most commonly from the septum, ear, or rib—into areas of the nose that require added structure or support. The grafts help reshape the nose, strengthen weakened areas, or restore airflow.

Why use a patient’s own cartilage (autologous grafts)? These are better tolerated by the body, minimize infection risk, and integrate more seamlessly with surrounding tissues compared to synthetic materials.

This biological compatibility significantly reduces the risk of foreign body reactions or long-term complications such as migration or extrusion—issues occasionally seen with silicone or Gore-Tex implants. Additionally, autologous grafts can be precisely sculpted to meet the patient’s specific anatomical and aesthetic needs.

When Cartilage Grafting Becomes Essential

Cartilage grafts are especially useful when:

• Structural integrity is compromised (e.g., collapsed tip or bridge)

• Airflow needs restoration (due to deviated septum or valve collapse)

• Previous surgeries have depleted nasal cartilage

In primary rhinoplasty cases, septal cartilage is often sufficient. However, in secondary or revision procedures—where prior surgeries may have removed or damaged internal structures—more robust material such as rib cartilage is required.

In Asian rhinoplasty, where bridge augmentation is common due to naturally low nasal dorsums, cartilage grafting provides a reliable means of creating height and definition without resorting to artificial implants.

Comparing Graft Sources: Rib vs. Septum vs. Ear

Each cartilage source has specific advantages:

• Rib Cartilage: Ideal for major structural support, especially in revision cases or bridge augmentation. Offers the largest volume and strength.

• Septal Cartilage: Typically used in primary rhinoplasty. Its central location makes harvest simpler with no external scars.

• Ear Cartilage: Suited for fine detailing (e.g., tip refinement). Less robust, but highly flexible.

Clinical Note: “Rib grafting is our go-to in complex cases. While harvesting adds a small chest incision, the support it provides is unmatched,” says Dr. Kim.

Ear cartilage is often used when septal cartilage has already been harvested or when only subtle reshaping of the nasal tip is required. While it lacks the structural rigidity of rib or septum cartilage, its curved shape can be advantageous in certain aesthetic applications.

Real Benefits—Aesthetic and Functional

Aesthetic Enhancements:

• Refined nasal tip contouring

• Improved bridge height and profile

• Enhanced nasal symmetry

Cartilage grafts allow surgeons to manipulate shape and structure with greater control and subtlety. By reinforcing weak or collapsing areas, grafts ensure the nose retains its shape over time, avoiding post-operative deformities like saddle nose or tip drooping.

Functional Gains:

• Corrected septal deviation

• Stabilized nasal valves

• Restored airway patency

Cartilage grafts are commonly used to bolster internal valves—the narrowest part of the nasal airway. When these collapse or weaken (a common cause of breathing difficulty), spreader or batten grafts can restore patency and dramatically improve nasal airflow.

Patients often report improved sleep quality, reduced snoring, and greater ease of breathing following functional rhinoplasty incorporating grafts.

Longevity & Tissue Harmony

Unlike implants that may shift or degrade, cartilage grafts typically remain stable over time. Because the tissue is natural and flexible, it adapts well to the nasal environment, leading to results that evolve harmoniously with facial changes over time.

Studies have shown that autologous grafts maintain their volume and position significantly longer than synthetic counterparts. The resorption rate is low, and when done with proper surgical technique, the graft integrates and becomes indistinguishable from native nasal structures.

This longevity is particularly crucial in younger patients, whose facial features continue to evolve. A well-placed graft offers adaptability while maintaining aesthetic integrity.

Key Role in Revision Rhinoplasty

In revision surgeries, grafting is not optional—it’s often the only path to a structurally sound and aesthetically pleasing nose. Cartilage from the rib is frequently used here to rebuild and restore areas compromised by earlier procedures.

Surgeons often face challenges such as scar tissue, asymmetry, and a lack of internal support. Cartilage grafts provide the raw material necessary to address these issues effectively. In fact, experienced revision rhinoplasty surgeons frequently rely on rib grafting to correct failed outcomes from prior surgeries performed with synthetic implants.

Safety, Recovery & Scarring

Modern cartilage grafting techniques are designed for minimal invasiveness. Rib cartilage harvest involves a small incision on the chest wall, usually hidden under the breast or in the natural skin fold.

The use of endoscopic assistance and layered closure techniques minimizes scarring and promotes faster healing. Nasal incisions are similarly well-concealed, typically inside the nostrils (closed approach) or within natural skin creases (open approach).

Safety Tips:

• Choose a board-certified surgeon with specialized grafting experience.

• Discuss risks like graft resorption, infection, or asymmetry.

• Follow postoperative care strictly for optimal healing.

Postoperative care may include avoiding strenuous activity, protecting the nose from trauma, and sleeping in an elevated position to reduce swelling. Most patients return to daily activities within 1–2 weeks.

Global Adoption & Surgical Trends

Cartilage grafting has become a global gold standard in rhinoplasty. In countries like South Korea—where facial harmony and subtle enhancements are prioritized—grafting is especially popular.

South Korean surgeons often lead global trends in natural-looking, high-precision nasal surgeries. With increasing international demand, clinics in Seoul attract patients from the U.S., Europe, and the Middle East seeking advanced revision and primary rhinoplasty procedures.

Medical tourism has further spotlighted elite clinics in Seoul. Surgeons like Dr. Kim at Kowon Plastic Surgery are known for crafting personalized, stable rhinoplasty results using advanced autologous grafting techniques.

Why Kowon Plastic Surgery Stands Out

• Over 10,000 rhinoplasties performed

• Expertise in rib cartilage grafting

• High patient satisfaction and natural-looking outcomes

Kowon Plastic Surgery emphasizes a balance of structure, proportion, and safety. Dr. Kim’s approach includes preoperative imaging, 3D simulation, and detailed consultations that educate patients about their unique nasal anatomy and surgical possibilities.

“Every nose has a unique history and structure. Our role is to reconstruct—not just reshape—in a way that fits the individual,” Dr. Kim shares.

Patients frequently cite improvements not only in appearance but in breathing, self-confidence, and overall quality of life.

Conclusion

Cartilage grafting isn’t just a surgical technique—it’s a cornerstone of modern rhinoplasty that ensures beauty doesn’t compromise function. For those seeking revision surgery, structural support, or natural-looking enhancement, autologous cartilage grafting offers a durable, biocompatible solution.

Its long-term reliability, biological safety, and aesthetic adaptability make it one of the most important developments in facial plastic surgery. Whether correcting nasal obstruction or crafting a more harmonious profile, cartilage grafting continues to elevate outcomes in rhinoplasty worldwide.