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It may be possible to just use ear cartilage. However in many cases rib cartilage (donated and autologous) may have to be used. A prior consultation and examination must be done before any decision is made. Rib cartilage, especially autologous (self) cartilage, is much stronger and can withstand the deforming forces of scarring after lenthening surgery. Donated rib cartilage carries with it the issue of resorption with time.