I guess they're saying it does matter now. I had a rib graft on a reconstructive revision rhinoplasty. The alar valve was 90% collapsed on one side. I had a primary to fix it but it collapsed again and on top of that I got the "shrink wrap effect" where the skin shrink wraps around the grafts, so you can see the outline of the grafts. On the secondary, rib cartilage was used to open my alar valve again and then crushed rib cartilage was wrapped in fascia to cover up the grafts from before. So far it's holding up (8 months) but you never really know for at least 2 years post-op. Hope this helps.