Becker Rhinoplasty Center
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DR BECKER IS NOW TREATING RHINOPLASTY PATIENTS BY TELEHEALTH.

During the COVID-19 state of emergency, in order to protect our patients and staff, but in order to communicate with patients and plan for the future, Dr Becker will communicate with potential rhinoplasty patients by Telehealth. Telehealth appointments may be scheduled on the phone (our operators our working remotely). Visits will be performed by audio or video discussion.

Becker Rhinoplasty Center
Central New Jersey
609-436-5740
Southern New Jersey
856-772-1617
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CENTRALNew Jersey
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  • Meet the Doctor
  • Procedures
    • Rhinoplasty
    • Revision Rhinoplasty
  • Photos
    • Bulbous Tip
    • Droopy Nose
    • Ethnic Rhinoplasty
    • Finesse Rhinoplasty
    • Nasal Bump
    • Nasal Fracture
    • Narrow Nose
    • Overprojected
    • Revision Rhinoplasty
    • Saddle Nose
    • Twisted Nose
    • Underprojected
    • Unique Issues
    • Upturned Nose
    • Wide Nose
  • Testimonials
    • Patient Reviews
    • Testimonial Videos
  • Videos
    • Testimonial Videos
    • Educational Videos
  • Patient Education
    • Nose Form & Function
    • A Patient’s Guide
    • Books & Publications
    • Revision Rhinoplasty Textbook
    • Rhinoplasty Education
    • Rhinoplasty Dissection Manual
  • Locations
    • Sewell Office
    • Voorhees Office

Harvesting Rib Graft

Cartilage is typically harvested (Fig. 2) from the eighth and ninth ribs or the confluence. If additional cartilage is required, the tenth rib also may be harvested. Bone may be har­vested with the ninth rib if desired.

A 4-cm to 6-cm incision overlying the eighth rib allows adequate exposure. Dissection proceeds to and then through the rib perichondrium. The muscle fibers can be separated in-stead of cut to minimize postoperative pain. Dissection around the rib is undertaken sub­perichondrially; the pleura is typically closely adherent to the perichondrium. With the graft completely separated from surrounding soft tissue, the graft is incised and delivered under direct vision. The surgeon may elect to place a malleable retractor beneath the rib as it is incised. Saline is placed in the surgical site and Valsalva or positive pressure applied to check for a pleural leak. If a pleural tear is identified, a pursestring suture closure is un­ dertaken around a red-rubber suction catheter. The surgeon then requests a TM Valsalva” from the anesthesiologist. The red rubber is then removed and the suture tightened. Saline may be placed in the wound and another Valsalva undertaken while the surgeon carefully in­spects for air bubbles. A standard, layered soft-tissue closure without a drain is accom­plished. Skin edge eversion can be accomplished with everting subcutaneous sutures.

A chest radiograph is obtained in all patients after rib harvest. In the rare instance of a difficulty, the surgeon may wish to consult the appropriate surgical colleague.

Cartilage Harvesting Rhinoplasty
Figure 2 A
Cartilage Harvesting Rhinoplasty
Figure 2 B
Cartilage Harvesting Rhinoplasty
Figure 2 C

Figure 2. Rib cartilage harvest. Cartilage is typically harvested from the eighth and ninth ribs. A 4 cm to 6 cm incision overlying the eighth rib allows adequate expo- sure (see also Chapter 11, Fig. 6). Dissection proceeds to and then through the rib perichondrium. Dissection around the rib is undertaken subperichondrially; the pleura is typically closely adherent to the perichondrium. With the donor rib completely separated from surround­ ing soft tissue, the graft is incised and delivered under di ­ rect vision. The surgeon may place a malleable retractor beneath the rib as it is incised.

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Sewell - 856-589-6673

Voorhees - 856-772-1617

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RHINOPLASTY EDUCATION

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REVIEWS

"Dr. Daniel Becker is the sweetest most caring person. It’s almost a year since I had a really bad nose bleeds and he was there for us, came to hospital in the snow on a Sunday just to fix me. He is so very special and always there when you need him. Love him!!!"

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