Facial plast Surg 2019; 35(01): 031-046
DOI: 10.1055/s-0039-1677801
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Current Practical Concepts for Using Rib in Secondary Rhinoplasty

Enrico Robotti
1  Department of Plastic and Reconstructive Surgery, Private Practice, Bergamo, Italy
Waldemar Brandao Penna
2  Department of Plastic Surgery, Private Practice, Belo Horizonte, MG, Brazil
› Author Affiliations
Further Information

Publication History

Publication Date:
13 February 2019 (online)


Rhinoplasty is universally considered as the most demanding procedure in facial plastic surgery. Secondary rhinoplasty is its crown jewel, even more complex, and likewise highly fascinating. The evolution of thought and practice in rhinoplasty in the last decades has been quick and steady, progressively acknowledging the importance of maintaining structure in primary rhinoplasty and rebuilding structure in secondary procedures. No longer is the paradigm to achieve a small, thin, and pointy nose, but rather a well-proportioned nose which looks natural, albeit elegant and breathing well. Rib is an essential tool in many secondary procedures, and thus some important concepts have to be well understood and some finesse points mastered. This will provide an elegant reconstruction, identical if possible, or at least not far apart, to what could be achieved by a well-executed primary rhinoplasty, while avoiding the feared luck of a bulky nose stuffed with grafts. These guiding concepts and specific nuances regarding harvesting rib and working with it are the scope and contents of this article.

Statement of Authorship

Both authors had substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data, drafting the article, or revising it critically for important intellectual content, and approved the final version to be published.