Auricular cartilage transplant—where to have it? Comparing ear scarring with nasal tip longevity

Auricular cartilage transplant is limited in the amount and strength of cartilage available from the ear, so the basic approach is to choose a facility that can assess whether your ear cartilage will be sufficient for your goals[1]. The outcome of nasal surgery varies greatly depending on the surgeon's skill and experience, and complications such as hematoma, deformity, and scarring can occur on the ear side as well[2]. For revision surgery requiring strong support, other cartilage sources such as rib cartilage may be considered[3].

Is ear cartilage enough? Check compatibility with your goals

First, you need to confirm whether ear cartilage will be sufficient. Ear cartilage is limited in amount and strength, and this limitation can affect long-term shape and may lead to revision surgery[1].

In secondary or later nasal surgeries, ear cartilage may weaken the nasal support over time, and the shape or nasal airway may not turn out as desired[1]. Tell the surgeon what shape you want and how much support you need, and ask them to explain whether ear cartilage is suitable for you.

What changes with the surgeon's experience?

The outcome of nasal surgery varies greatly depending on the surgeon's skill and experience[2]. This is because there are many surgical approaches, materials, and types of cartilage to transplant, and the combination of these elements makes a difference[2].

Research reviews on nasal surgery using rib cartilage also conclude that skill, patient selection, and long-term follow-up are important[4]. Ask how much experience the surgeon has with nasal surgery and cartilage transplantation.

Are there explanations about ear scarring and shape changes?

When cartilage is removed from the ear, complications can occur on the ear side as well. These include hematoma (blood accumulation), change in ear shape, noticeable scarring, hypertrophic scarring, and keloid formation[2].

It has also been noted that complications on the ear side have not yet been adequately reported[5]. Before surgery, ask where the cartilage will be taken from and where the scar will remain. If you have a tendency to form keloids, mentioning this beforehand will make the discussion easier.

How to choose compared to rib cartilage or nasal cartilage?

Ear cartilage is not the only answer. In revision surgery, the nasal septal cartilage is often insufficient, so rib cartilage or ear cartilage is frequently used[3].

In a review of 888 cases using rib cartilage, complications occurred in about 7% and satisfaction was about 92%[4]. However, the burden of harvesting cartilage from the chest and the possibility of needing revision surgery should be explained beforehand[4].

Some facilities use ear cartilage sparingly due to cartilage quality and the burden on the ear side[6]. In 43 cases of contracted nose from repeated surgery, a combination of rib cartilage and ear cartilage with skin was used, and no recurrence was seen at 1 year[7]. The key is whether the surgeon will explain the reasoning behind which cartilage is chosen.

Where to have it done? A guide when you are unsure

During consultation, ask about the following points:

Compatibility with your goals: Can the surgeon explain whether ear cartilage will be sufficient or if other cartilage is needed?[1][3]

Experience: How much experience does the surgeon have with nasal surgery and cartilage transplantation?[2]

Explanation about the ear side: Is there discussion about where cartilage will be taken, scarring, hematoma, and keloid risk?[2]

Long-term outcomes: Will the surgeon discuss shape changes over time and their approach to revision?[1][4]

Whether ear cartilage alone is sufficient for your nose or whether rib cartilage should be combined cannot be decided from an article alone. During examination, have the surgeon assess your current nasal support, surgical history, and ear shape, and decide together on how to harvest and use cartilage.