This patient had a previous rhinoplasty and rib graft placement by an outside surgeon. Unfortunately, the rib warped in this patient and he developed a postoperative asymmetry. The rib is outlined in white in the middle photograph to demonstrate its location. The previous surgeon had used a rib graft which was too short and carved it along the periphery. Rib Rhinoplasty - Costal Cartilage Grafting
An external rhinoplasty approach was used and a longer piece of costal cartilage graft was carved in a symmetric fashion to prevent warping. Dr. Shah has written several papers on costal cartilage and rib warping and has lectured on techniques to minimize rib warping. Dr. Shah is one of the few surgeons in the country who uses rib cartilage to provide symmetrical natural results.
The patient's postoperative photograph demonstrates a strong nasal profile and a straight natural contour. Since this patient has wide facial features (wide face, widely set eyes, etc), his nasal tip was left slightly larger to "fit his face".
More patient photographs can be seen in Dr. Shah's office.