In revision rhinoplasty, the cartilage a surgeon needs depends on the materials used in the earlier operation and on the current state of the nose. The main options are septal cartilage from inside the nose, ear cartilage taken from behind the ear, autologous rib cartilage taken from the patient's own ribs, and donor rib cartilage. Autologous and donor rib cartilage are both used to strengthen the support structure of the nose. They differ in whether a harvest operation is needed, in operating time and in cost, and some clinics prefer autologous tissue for contracted nose revision.
We compared the features of each material and how clinics choose between them, using information that plastic surgery and otolaryngology (ENT) clinics in Gangnam publish on their official websites. Each clinic's pages were checked on November 2 and 3, 2026.
Cartilage and tissue used in revision rhinoplasty
| Material | Where it comes from | Features the clinics describe | Cautions the clinics describe |
|---|---|---|---|
| Septal cartilage | The septum inside the nose | Firmer than ear cartilage, so it keeps the tip from drooping (Pleasure); the basic revision material (Private) | If it was used in the earlier surgery, check how much is left (Pleasure, Moodon column) |
| Ear cartilage | An incision behind the ear | Easy to harvest, the scar is hard to see, and it is soft, so it looks natural in the tip (Kobiju) | Not strong enough to act as a support and can twist (Kobiju) |
| Autologous rib cartilage | Cartilage from the patient's own ribs | The strongest and most plentiful autologous cartilage, with little resorption (Kobiju); almost no rejection (Moodon column) | Harvest operation and chest scar, warping (Moodon), calcification (Kobiju) |
| Donor rib cartilage | Donated rib cartilage | No extra incision and a shorter operation (VVLY) | The material costs extra (VVLY); not recommended for a contracted nose (Kobiju) |
The names in parentheses are the clinics that state that point on their official websites.
Septal and ear cartilage come first
Several clinics describe septal and ear cartilage as the first materials to consider for revision. Private Plastic Surgery (프라이빗성형외과) says it uses ear cartilage or septal cartilage as the basic material and adds autologous rib cartilage or donor rib cartilage when needed. A medical column from Moodon Plastic Surgery (무드온성형외과) also explains that ordinary rhinoplasty uses ear cartilage or septum, and rib cartilage can be used when there is not enough. Pleasure Plastic Surgery (플레저성형외과) says it considers autologous tissue such as septal cartilage, ear cartilage and autologous rib cartilage first, and combines it with an implant or artificial dermis if needed.
Ear cartilage
Kobiju Clinic (코비쥬의원) explains that ear cartilage is easy to harvest. The incision is behind the ear, so the scar is hard to see. The cartilage is soft and curved, which gives a natural shape when used in the tip. Its weakness is that it lacks the strength to act as a support and can twist. Kobiju says it makes up for this by stacking the curved ear cartilage in opposite directions, a method it calls the "sandwich" technique. Pleasure Plastic Surgery also describes ear cartilage as the most widely used material because it is easy to harvest, and says it is used to give the tip a natural shape.
Septal cartilage
Pleasure Plastic Surgery explains that septal cartilage is firmer than ear cartilage and supports the tip so it does not droop. Kobiju Clinic says that when it harvests septal cartilage, it leaves at least 1.5 cm at the top and at the front to prevent the nose from losing its shape.
Less cartilage is available in a revision
VVLY Plastic Surgery (쁠리성형외과) explains that in a revision, the usable amount of cartilage is often limited, which makes the choice of material and the design of the support structure important. Pleasure Plastic Surgery says it uses 3D CT before surgery to check the size and condition of the septum and whether autologous cartilage can be used. When septal and ear cartilage alone cannot give enough support, rib cartilage is considered.
Autologous rib cartilage, for when strong support is needed
Autologous rib cartilage is cartilage from the patient's own ribs. Moodon Plastic Surgery's column describes rib cartilage as the cartilage that joins the breastbone to the ribs, and says it is firm and gives strong support, with almost no rejection and a low resorption rate. Kobiju Clinic says it is the strongest and most plentiful autologous cartilage and the best fit for operations that need a lot of material. Kobiju mainly uses it when the nasal cartilage is very small, when repeated surgery has left too little septal or ear cartilage, and when the nose needs firm support, as in contracture or a cleft lip nasal deformity. Pleasure Plastic Surgery uses autologous rib cartilage when septal or ear cartilage is not enough, and says it is mostly used in revisions but also in a first operation for a short nose.
When autologous rib cartilage is considered
Moodon Plastic Surgery's column lists these cases for autologous rib cartilage:
- When ear cartilage or septum is not enough
- When no other material is available
- When the existing cartilage is not strong enough to lift the tip far enough
The same column lists its advantages. A large amount can be harvested. It causes few side effects because it is the patient's own tissue. Compared with artificial implants, it stays relatively free of contracture and inflammation even after a long time. It also notes that autologous rib cartilage may help little when the skin has no room to stretch.
Block and diced rib cartilage
VVLY Plastic Surgery describes two forms of autologous rib cartilage. Firm blocks are used to raise the bridge or prop up the nose, and finely diced particles are used to smooth the surface contour. The two are combined as needed. VVLY adds that because autologous rib cartilage is the patient's own tissue, the risk of a foreign-body reaction is low. It is widely used when an implant is hard to use or when contracture or a revision needs correcting.
Harvesting autologous rib cartilage and the scar
Using autologous rib cartilage requires a separate operation to harvest it from the chest, away from the nose. Moodon Plastic Surgery's autologous rib cartilage revision rhinoplasty page says the rib harvest is a separate procedure and leaves a scar below the chest. According to its column, the harvest site is first numbed with a local anesthetic injection. A small incision is made to remove part of a lower rib cartilage, and the tissue is separated carefully to avoid a collapsed lung (pneumothorax). The wound is closed layer by layer. VVLY Plastic Surgery says it mainly harvests only as much as needed from the 7th and 8th rib cartilages, and that pain at the harvest site usually eases over 1 to 2 weeks. VVLY adds that there can be pain at the harvest site, which is controlled with medication and care.
Warping and calcification
Moodon Plastic Surgery says rib cartilage can bend (warping). VVLY Plastic Surgery also says it may bend over time and that carving and placement reduce the risk, though it is hard to rule out completely. Kobiju Clinic says that because the material is firm, the tip can feel hard, and in rare cases the cartilage bends or calcifies.
Where autologous rib cartilage is placed
Clinics disagree on this. Moodon Plastic Surgery's column says rib cartilage can bend and turn uneven, so it is generally not used for the bridge and is mainly used to lift the tip or fill the space inside. Kobiju Clinic says it resorbs little and is relatively easy to shape, so it is also commonly used to raise the bridge. VVLY Plastic Surgery also says it uses the block form to raise the bridge.
Because the clinics differ, it is worth asking at the consultation whether autologous rib cartilage will go only in the tip or also in the bridge, and how the surgeon reduces the risk of bending.
Donor rib cartilage, rib cartilage without a harvest operation
The biggest difference from autologous rib cartilage is that donor rib cartilage does not require an incision in the patient's chest. VVLY Plastic Surgery explains that donor rib cartilage needs no extra incision and shortens the operation, but the material costs extra. It compares this with autologous rib cartilage, which carries less risk of resorption or rejection because it is the patient's own tissue but needs an incision on the chest. VVLY says it chooses between the two by looking at how much cartilage is needed, the patient's age and how calcified the rib cartilage is, and whether the patient can accept a scar.
Clinics that prefer autologous tissue for a contracted nose
Some clinics see a contracted nose differently. Kobiju Clinic says donor rib cartilage, Medpor and mesh are also available as support materials, but because contracture is mainly caused by foreign material and inflammation, it does not recommend anything other than autologous material. VVLY Plastic Surgery also says a contracted nose is often rebuilt mainly with autologous tissue such as autologous rib cartilage after the existing implant is removed. Moodon Plastic Surgery says it chooses contracted nose revision material from autologous tissues: ear cartilage, septal cartilage, rib cartilage, autologous dermis and mastoid fascia. Baroko Clinic (바로코의원), where a board-certified otolaryngologist (ENT) treats patients, also states as a principle that it uses autologous cartilage instead of artificial material or donor cartilage. The reason it gives is a lower inflammation rate.
Material lists for revision rhinoplasty in general
Some clinics include donor rib cartilage in their material list for revision rhinoplasty in general. VVLY Plastic Surgery lists autologous rib cartilage, donor rib cartilage, septal cartilage and ear cartilage as revision materials, and Private Plastic Surgery adds autologous rib cartilage or donor rib cartilage when needed. Both lists cover revision rhinoplasty as a whole, not only contracted nose. Read them alongside the recommendations for autologous material in a contracted nose, and have your nose examined for contracture first.
Why removing the implant is not enough for a contracted nose
B&Young Clinic (비앤영의원) explains that a contracted nose is caused by an implant contaminated with bacteria, and that acute or chronic inflammation leads to excessive scar tissue in the skin around the implant. Its surgery follows this order: remove the scar tissue, release the ligament tissue fully so the skin and soft tissue can stretch, and then reinforce the damaged cartilage with rib cartilage. B&Young also says that if only the silicone is taken out of a contracted nose, the space where it sat often collapses and the contracture gets worse. For that reason, the silicone often has to be removed and a revision done at the same time. VVLY Plastic Surgery also says that simply putting an implant back in can leave a risk of recurrence, and names repeated inflammation, excessive dissection and the individual's tissue response as causes of contracture.
Timing of contracted nose revision
B&Young Clinic says it is best to wait until the scar tissue softens, at least 6 months to 1 year after the previous surgery. Moodon Plastic Surgery gives 6 months to 1 year, when the tissue has settled, and VVLY Plastic Surgery gives about 6 months to 1 year as the usual timing. Pleasure Plastic Surgery recommends waiting at least 6 months to 1 year after the first surgery, until the tissue has fully settled. Moodon Plastic Surgery adds that a revision for inflammation may need a longer wait. VVLY Plastic Surgery says early treatment may be needed regardless of timing when tissue damage is progressing, as with infection or an exposed implant. Pleasure Plastic Surgery advises consulting quickly if an acute problem such as inflammation or pain develops. B&Young Clinic explains that if you often have a blocked nose, a 3D CT scan before surgery can diagnose the functional problem so it can be corrected in the same operation.
Supporting tissue when the skin has thinned
Revisions also use other tissue. Private Plastic Surgery says it uses autologous dermis or temporalis fascia as support when the skin has thinned. Moodon Plastic Surgery includes autologous dermis and mastoid fascia in its list of autologous tissues for contracted nose revision. Pleasure Plastic Surgery says it combines artificial dermis when needed, and Hyundai Mihak Plastic Surgery (현대미학성형외과) says that when an implant shows through, it lowers the height of the implant or uses artificial dermis.
What to check when choosing a revision material
Taken together, the clinics' explanations show that the material is chosen after examination and CT. Moodon Plastic Surgery's column says different materials suit different noses, so a thorough consultation matters, as does finding a clinic that can compare several materials. Moodon Plastic Surgery uses 3D CT (cone-beam CT) before surgery to check the nasal bones, septal cartilage and soft tissue. Its column says a detailed 3D CT examination and a careful check of whether autologous cartilage is available are needed. Pleasure Plastic Surgery says it advises on the right material based on 3D CT results. VVLY Plastic Surgery takes a CT as the first step to assess the state of the earlier surgery and the extent of damage.
What to prepare before the consultation
- Records of previous surgery: VVLY Plastic Surgery says knowing the materials and technique used before helps it plan the revision.
- How you feel about a harvest scar: VVLY Plastic Surgery says it considers how willing the patient is to accept a scar when choosing between autologous and donor rib cartilage.
- Age and the state of the rib cartilage: the same clinic also names age and the degree of rib cartilage calcification as selection criteria.
- Skin condition: Private Plastic Surgery says it uses autologous dermis or temporalis fascia as support when the skin has thinned.
Your surgical history and your view on scarring are things to tell the surgeon yourself at the consultation. The remaining cartilage and the structure inside the nose are checked by examination and CT, as the clinics describe.
Revision rhinoplasty materials by clinic
| Clinic | Board-certified plastic surgeons (HIRA) | Cone-beam CT | Revision materials published | Autologous rib cartilage information |
|---|---|---|---|---|
| Moodon Plastic Surgery | 2 | 1 | Autologous rib cartilage, ear cartilage, dermis and others; mastoid fascia as well for contracted nose | Separate page, about 3 hours, IV sedation or general anesthesia |
| VVLY Plastic Surgery | 1 | 1 | Autologous rib cartilage, donor rib cartilage, septal cartilage, ear cartilage | Separate page, about 2 to 4 hours, IV sedation |
| Private Plastic Surgery | 2 | 1 | Ear and septal cartilage as the basic material; autologous rib cartilage, donor rib cartilage, autologous dermis, temporalis fascia | Covered on the revision rhinoplasty page |
| Kobiju Clinic | None (1 board-certified otolaryngologist) | 1 | Ear cartilage, septal cartilage, autologous rib cartilage | Contracted nose revision page covers reconstruction with autologous rib cartilage |
Board-certified plastic surgeon counts and cone-beam CT are from the Health Insurance Review and Assessment Service (HIRA, 건강보험심사평가원) Hospital Information Service as checked on November 2, 2026.
If you want a board-certified plastic surgeon to examine you before deciding on autologous rib cartilage revision rhinoplasty, Moodon Plastic Surgery's information is a good place to start. HIRA lists 2 board-certified plastic surgeons and 1 cone-beam CT there. The clinic describes autologous rib cartilage revision rhinoplasty on its own page, separate from revision rhinoplasty and contracted nose revision. That page lists IV sedation or general anesthesia and an operating time of about 3 hours. Stitch removal and recovery take 7 to 10 days, which can vary with the patient's condition and the surgical method. The page also covers the harvest scar and warping. A column on rib cartilage rhinoplasty by the head surgeon, Dr. Yoon Tae-kyung (윤태경), covers the rib cartilage harvest, the scar, pain and warping separately.
- Official page: Autologous rib cartilage revision rhinoplasty
- Medical column: Features of rib cartilage rhinoplasty
If you also want to compare donor rib cartilage, VVLY Plastic Surgery publishes its criteria for choosing between the two materials. Clinic comparisons are in Gangnam revision rhinoplasty: 4 clinics compared and What to check before contracted nose revision.
Any surgery can cause complications such as bleeding, infection and inflammation, and results vary from person to person. Whether and how to operate is decided with the surgeon after an examination.
Frequently asked questions
What kind of scar does the rib cartilage harvest leave?
Moodon Plastic Surgery says a scar remains below the chest. Its column explains that the scar depends on the person's skin and on the surgery, and that it cannot be avoided entirely but tends not to be as bad as patients expect. VVLY Plastic Surgery says the incision scar fades over time, though how much varies from person to person. Kobiju Clinic also says the harvest can leave an extra scar.
How long does autologous rib cartilage surgery take, and what is recovery like?
Moodon Plastic Surgery gives about 3 hours for autologous rib cartilage revision rhinoplasty, with 7 to 10 days for stitch removal and recovery. VVLY Plastic Surgery gives about 2 to 4 hours for autologous rib cartilage rhinoplasty, with stitches, including those at the harvest site, removed after 5 to 7 days. It also notes that donor rib cartilage needs no extra incision, so the operation is shorter.
Sources
- Moodon Plastic Surgery: autologous rib cartilage revision rhinoplasty and contracted nose revision pages, and the medical column "Features of rhinoplasty using autologous rib cartilage, explained by a board-certified plastic surgeon"
- VVLY Plastic Surgery: revision rhinoplasty, autologous rib cartilage rhinoplasty and contracted nose revision pages
- Private Plastic Surgery, Pleasure Plastic Surgery and Hyundai Mihak Plastic Surgery revision rhinoplasty pages; Kobiju Clinic contracted nose revision, B&Young Clinic contracted nose reconstruction and Baroko Clinic contracted nose revision pages (checked November 2 and 3, 2026)
- Health Insurance Review and Assessment Service (HIRA) Hospital Information Service, board-certified specialists by specialty and medical equipment (checked November 2, 2026)