By Dr. Kailash Narasimhan | St. Petersburg & Tampa, Florida
Modern rhinoplasty is far more than cosmetic reshaping—it requires a deep understanding of nasal architecture, airflow mechanics, and long-term structural stability. One of the most essential tools in achieving natural, durable results is the cartilage graft. Cartilage grafts play a crucial role in both cosmetic and functional rhinoplasty, offering support, refinement, and improved breathing for patients of all ages and backgrounds.
As a double board-certified facial plastic surgeon serving St. Petersburg, Tampa, and the Tampa Bay region, I perform cartilage grafting routinely in primary, revision, and reconstructive rhinoplasty. This long-form guide explains when cartilage grafts are needed, the types of grafts commonly used, and what patients can expect before, during, and after surgery. Whether you are researching a first-time rhinoplasty or considering revision surgery, this article will give you a clear understanding of how grafting contributes to strong, beautiful, and lasting outcomes.
A cartilage graft is a small piece of cartilage that is added to the nose during surgery to reinforce structure, improve aesthetics, or help restore normal breathing. Cartilage grafts are typically sculpted from:
Cartilage behaves predictably, integrates well with existing structures, and remains stable over time. Because the nose is a central feature of the face—both aesthetically and functionally—it requires a strong, flexible, and dependable framework. Cartilage is the material that makes this possible.
While some patients require only subtle adjustments, others need reinforcement to maintain shape, support the airway, or correct deformities caused by trauma, over-resection, or aging. Cartilage grafts help surgeons like me:
Some noses have naturally thin or weak cartilage, particularly the tip and middle vault. Over time, untreated weakness can lead to collapse, asymmetry, or breathing problems.
Structural rhinoplasty focuses on both form and function. Grafts such as spreader grafts, batten grafts, and lateral wall grafts are essential tools to restore proper airflow.
Tip grafts and onlay grafts give surgeons the ability to refine contours with extreme precision—especially important for patients seeking a natural, elegant result.
The nasal bridge and tip rely on strong internal architecture. When cartilage is removed or reshaped during surgery, grafts help preserve long-term stability.
Nasal fractures, cartilage softening, and age-related structural changes sometimes require grafting to restore a straight, functional nasal framework.
Revision rhinoplasty is one of the most complex procedures in facial plastic surgery. Grafting is often required because the original support structures were weakened or removed.
In short: cartilage grafts are the foundation of natural, long-lasting rhinoplasty results.
Not every rhinoplasty requires cartilage grafting. But many do—particularly those involving structural or functional changes.
Below are the most common situations in which I recommend or utilize cartilage grafts in my Tampa and St. Petersburg practice.
In first-time rhinoplasty, cartilage grafting may be needed to:
For patients with soft cartilage, thicker skin, or ethnic nasal features, grafting can provide the support necessary for refined yet stable results.
Revision rhinoplasty is one of the most frequent reasons I utilize rib or ear cartilage grafts. Prior surgery may have:
Cartilage grafts in revision cases help rebuild the framework, restore balance, and improve long-term breathing.
When a patient has trouble breathing due to structural issues, I may use:
These widen the middle part of the nose (internal nasal valve), one of the most common causes of airway obstruction.
These reinforce the nostril walls (external nasal valve), preventing collapse during inhalation.
These strengthen the tissue that collapses inward during breathing.
I frequently combine functional techniques with cosmetic goals in one procedure.
A broken nose or cartilage injury can lead to:
Cartilage grafts rebuild lost structure, straighten the nose, and restore a natural profile.
Some patients naturally have a low nasal bridge or want dorsal refinement. Cartilage grafting—particularly rib cartilage—is highly effective for:
Over time, nasal cartilage weakens and soft tissues change. Grafts strengthen aging structures to maintain shape and improve overall nasal harmony.
Not all grafts are created equal. Each has unique properties and ideal uses. Below is an in-depth look at the most common types.
Autologous cartilage is the gold standard for most rhinoplasties because it is biologically compatible and long-lasting.
Source: From the nasal septum Best for: Primary rhinoplasty, structural grafts, spreader grafts, tip support
Septal cartilage is straight, strong, and easy to sculpt, making it the preferred option in most primary cases. It is ideal for:
Advantages:
Source: Behind the ear Best for: Curved or delicate areas of the nose
Ear cartilage is flexible and naturally curved. I often use it for:
Advantages:
Source: Small portion of the patient’s rib Best for: Major reconstruction, revision cases, or large dorsal augmentation
Rib cartilage is the strongest and most abundant source. It is necessary when large volumes of cartilage are required.
Common uses include:
Advantages:
Rib cartilage requires more harvesting skill due to warping potential, but with proper carving and stabilization, results are predictable and long-lasting.
Also known as allograft cartilage, this is sterilized and processed rib cartilage from a donor. Modern processing techniques significantly reduce the risk of resorption or warping.
Best used when:
Cadaveric cartilage works well in many cases and reduces operative time and recovery discomfort. However, I always discuss all pros and cons so the patient can make an informed decision.
Common synthetic materials include:
These can play a role in select patients, especially for dorsal augmentation, but they have higher risks of:
For these reasons, I typically prefer autologous cartilage, especially for functional and revision rhinoplasty.
Every patient’s nose is unique. During consultation, I consider:
I then create a customized surgical plan that balances beauty, function, and structural integrity.
Rhinoplasty with cartilage grafting is performed under general anesthesia in an accredited surgical facility. The steps may include:
Most surgeries take 2–4 hours depending on complexity, with revision or rib graft cases taking longer.
Recovery is similar to standard rhinoplasty, with some additional considerations depending on graft location.
Patients often notice significant improvement as swelling resolves over the first few months.
Full refinement takes 9–12 months, especially for the nasal tip.
As with any surgery, there are risks, which include:
Choosing an experienced, fellowship-trained facial plastic surgeon significantly reduces these risks.
No. Many patients do not. The need depends on anatomy, goals, and whether this is primary or revision surgery.
Yes. It is the most reliable option in cases requiring strong, abundant cartilage.
Ear cartilage harvest does not change the visible ear shape. Rib cartilage is taken from a small incision hidden under the breast fold or chest line.
Autologous cartilage typically lasts a lifetime.
Yes—grafts are essential in repairing nasal valve collapse and restoring proper airflow.
Your nose is one of your most defining features. Choosing a surgeon with deep expertise in cartilage grafting is essential for achieving balanced, natural, and durable results.
If you're considering rhinoplasty with cartilage grafting—whether cosmetic, functional, or revision—I invite you to schedule a private consultation.
📍 St. Petersburg, FL | Tampa, FL 📞 Phone: 727-289-7119 🌐
I look forward to helping you achieve a nose that looks beautiful, breathes well, and feels authentically you.
