Cartilage-Grafted Rhinoplasty

Cartilage-shielded rhinoplasty utilizes a synthetic implant to elevate the nasal bridge while harvesting your own ear cartilage (or Megaderm) to cover the nasal tip. This creates a protective buffer between the implant and the skin, minimizing the long-term risks of redness and implant visibility. It is suitable for low nasal bridges with a relatively good tip structure and sufficiently thick skin; it cannot correct bulbous, short, or upturned nasal tips.

Medically reviewed by BS.Ths.CKII Nguyễn Xuân Vũ — BonBoz Clinic

Why Is Tip Grafting Necessary?

Using only an implant that extends to the nasal tip can, over time, exert pressure on the thin overlying skin, causing redness, implant show-through, or even skin perforation. An ear cartilage graft applied to the nasal tip is living autologous tissue that redistributes pressure and nourishes the skin—making the procedure significantly safer over the long term compared to a traditional "implant-only" rhinoplasty.

What the Technique Can and Cannot Do

What it can do: raise the nasal bridge into a high, straight profile; protect the nasal tip; allow for a fast recovery (swelling subsides in 1–2 weeks). What it cannot do: refine a bulbous tip, lengthen a short or upturned nose, or reinforce a weak columella—because it does not alter the underlying tip cartilage framework. Patients with a large or short tip who only undergo tip-grafted rhinoplasty often end up with a higher bridge while the tip remains unrefined.

Materials

Soft silicone or Surgiform (ePTFE) implants are selected based on nasal anatomy and skin thickness; ear cartilage is harvested through a small incision behind the ear without affecting the ear's shape; Megaderm (processed acellular dermal matrix) is an alternative for patients who prefer not to harvest ear cartilage, though it is less durable than autologous cartilage. The surgeon will explain the pros and cons of each option before you make a decision.

Recovery

Swelling and bruising are most noticeable during the first week and significantly subside in the second week; sutures are removed on days 5–7; the shape stabilizes within 1–3 months, with final results settling in 6–12 months. Avoid physical impacts, heavy-rimmed glasses, and sleeping on your side pressing against the nose for 4–6 weeks.

At BonBoz

Dr. Nguyen Xuan Vu, MSc, Specialist Level II, personally conducts the examination, measures facial proportions, and assesses skin thickness and nasal tip anatomy. If a cartilage-grafted rhinoplasty is sufficient, it will be recommended; if the tip requires structural reshaping, he will be upfront about the need for a semi-structural or structural rhinoplasty—never compromising technique for a lower price. The doctor directly performs the surgery from start to finish.

How is it performed?

Local anesthesia (with optional pre-anesthesia/sedation). Ear cartilage is harvested through a small incision behind the ear, followed by closure. An intranasal incision is made to dissect the pocket for the implant; the custom-carved implant is placed, and the harvested ear cartilage is secured to graft the nasal tip, followed by suturing. An external splint is applied for stabilization. Procedure time: 60–90 minutes.

Before the procedure

Undergo a general medical examination and routine tests (complete blood count, coagulation profile, blood glucose); discontinue anticoagulants/aspirin and supplements that affect blood clotting as instructed for 1 week; refrain from smoking 2 weeks before and after the procedure; fast for 6 hours if receiving intravenous sedation; inform the physician of any underlying medical conditions, allergies, and history of keloids.

After the procedure

Splint worn for 5–7 days; swelling and bruising are most visible in week 1 and subside in week 2; suture removal on days 5–7; take prescribed medications, apply cold compresses for the first 48 hours, sleep on your back with your head elevated for 2–4 weeks; avoid heavy-framed glasses and any impact for 4–6 weeks; attend scheduled follow-ups (days 2, 7, 30, and 90); final results achieved within 6–12 months.

Possible risks — your doctor explains them before treatment

Swelling and bruising for 1–2 weeks; numbness at the nasal tip for several weeks
Infection (rare, requires prompt treatment)
Implant deviation caused by physical impact or improper pocket dissection
Long-term skin redness or visible implant contour if the skin is thin, despite grafting—though the risk is lower than without grafting
Contracture or deformity requiring revision (low incidence)
The retroauricular incision fades over time; keloids are rare and typically occur only in predisposed individuals

Who should NOT have this?

Bulbous, short, upturned tip with a weak columella — semi-structural/structural rhinoplasty is required; cartilage-grafted rhinoplasty alone is insufficient
Extremely thin nasal tip skin (entirely autologous cartilage should be considered)
Failed or contracted previous rhinoplasty (structural revision rhinoplasty required)
Active facial infection, severe cystic acne on the nose
Uncontrolled underlying medical conditions (diabetes, cardiovascular disease, coagulopathy); currently pregnant
Under 18 years of age (nasal framework not yet fully developed)

BS.Ths.CKII Nguyễn Xuân Vũ

Department of Plastic and Aesthetic Surgery

Master of Medicine and Pharmacy — Specialist Level I Surgical Resident, Hue University of Medicine and Pharmacy (2014–2017)
Specialist Level II Doctor in Plastic and Aesthetic Surgery
Specialist Level I in Plastic and Aesthetic Surgery — Pham Ngoc Thach University of Medicine; Specialist Level II in Healthcare Management — University of Public Health
Specialty Certificate in Orthopedics and Traumatology and Certificate in Plastic and Aesthetic Surgery (2017)
Medical Practice License No.: 007827/ĐL-CCHN — Issued by Dak Lak Province Department of Health on 04/12/2017
Over 15 years of experience, more than 20,000 surgeries
Specialist Level II Doctor in Plastic and Aesthetic Surgery at Ho Chi Minh City Hospital of Dermatology (2020–present); previously Lead surgeon for major and minor procedures at Sao Han Hospital (2018–2020)
Member of international humanitarian organizations Operation Smile and ReSurge International — performing pro bono reconstructive surgeries for patients with congenital deformities, cleft lip, cleft palate, and ptosis (2022–present)
Affiliated with Alcon Pharmaceutical (USA)
Member of the Korean College of Cosmetic Surgery (KCCS)
Medical Director of BonBoz Clinic

Đặt lịch với bác sỹ

Book a consultation with a doctor

Choose a date, time slot and doctor — the clinic calls to confirm within 5 minutes during opening hours. Free consultation, no commitment.

Full name

Phone number

Preferred date · Preferred time · Doctor

Preferred date

Preferred time

Doctor

The clinic will call to confirm within 5 minutes during opening hours (08:00–20:00, daily). This is not yet a confirmed slot.

I agree to let BonBoz contact me for consultation using the information I provided, and I have read the Personal Data Protection Policy.

You do not have to describe your health condition here — you can discuss it directly with the doctor at your visit.

Free consultation — no obligation, no sales pressure.

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Frequently asked questions

How is cartilage-graft rhinoplasty different from standard rhinoplasty?

An extra layer of ear cartilage is used to graft the nasal tip, protecting the skin and reducing the long-term risk of redness and implant show-through. The nasal bridge is still augmented with synthetic implants.

Does harvesting ear cartilage cause ear deformity?

No. A small portion of conchal cartilage is harvested through a discreet incision behind the ear, preserving its natural shape; mild discomfort lasts for a few days.

How long does the swelling last?

Swelling and bruising are noticeable in the first week and subside significantly by week 2; the nose shape stabilizes within 1–3 months, with final results settling in 6–12 months.

How long do the results last?

The implants and cartilage remain stable for the long term if no complications arise; results do not have a fixed "expiration date," though natural skin aging continues.

Does the procedure hurt?

Local anesthesia is administered, so there is no pain during surgery; post-operative tightness and mild ache last a few days and are well-managed with medication.

Can a bulbous nasal tip be treated with cartilage-graft rhinoplasty?

Cartilage grafting does not reduce tip size. Achieving a refined tip requires semi-structural or structural rhinoplasty — your surgeon will advise you directly on this.

Is Megaderm as durable as ear cartilage?

It is less durable and may partially resorb over time; it serves as an alternative for those who do not wish to undergo ear cartilage harvesting.

When can I wear glasses and apply makeup again?

Light makeup can be applied after 1–2 weeks once incisions have healed; heavy-framed glasses should be avoided for 4–6 weeks.

Can a cartilage-grafted nose be revised in the future?

Yes; because cartilage grafting preserves healthy tissue, revision surgery (if needed) is more straightforward than in cases of simple implant placement with skin thinning and redness.

Who performs the surgery at BonBoz?

Dr. MSc. Specialist II Nguyen Xuan Vu, specializing in General and Plastic Surgery, directly conducts the consultation and performs the entire surgery from start to finish.