- •
The use of costal cartilage in rhinoplasty carries with it a risk of both donor site and rhinoplasty complications. The decision to use costal cartilage should be made after considering the alternative sources of cartilage grafts.
- •
After cartilage is harvested, the integrity of the chest wall and the absence of pneumothorax should be confirmed.
- •
Costal cartilage has a significant risk of warping. Various technical considerations allow the surgeon to take advantage of or to minimize the warping of
Costal Cartilage Grafts in Rhinoplasty
Section snippets
Key points
Treatment goals and planned outcomes
Every rhinoplasty procedure has multiple goals. Foremost is the resolution of all the concerns of the patient. The procedure should be safe with a minimal risk of complications. Patient satisfaction with an achievement of the desired esthetic and functional goals is central to a good outcome. Technically, the procedure should be based on sound principles of surgery, healing, and esthetics.
In rhinoplasty, favorable outcomes are achieved as a result of careful analysis, diagnosis, communication,
Potential complications and management
Potential donor site complications include infection, pneumothorax, bleeding, hematoma, and pain. Recipient site complications include graft sizing issues, graft malposition, graft mobility, and warping. The donor site complications are relatively uncommon, but include persistent pain, seroma, and wound issues.16, 17
Among the most significant risk during the execution of costal cartilage harvesting is pneumothorax. Pneumothorax has been stated to occur in more than 20% of the time during costal
Summary
The limitations of available septal and auricular cartilage may compromise the results of a rhinoplasty procedure when restricted to the use of those 2 donor sites. The rib cage provides an enormous reserve of costal cartilage that can be carved into a variety of grafts necessary for the successful execution of several rhinoplasty techniques. In many circumstances, the available volume and characteristics of costal cartilage are optimal for a successful rhinoplasty operation. As with every
References (19)
- et al.
Ethnic rhinoplasty
Clin Plast Surg
(2010) - et al.
Asian rhinoplasty
Clin Plast Surg
(2010) Considerations in ethnic rhinoplasty
Facial Plast Surg
(2003)- et al.
Use of autologous costal cartilage in Asian rhinoplasty
Plast Reconstr Surg
(2012) Discussion: use of autologous costal cartilage in Asian rhinoplasty
Plast Reconstr Surg
(2012)- et al.
The evolution of open structure rhinoplasty
Arch Facial Plast Surg
(2003) - et al.
Open structure rhinoplasty
Clin Otolaryngol Allied Sci
(1993) - et al.
Irradiated homograft rib cartilage in facial reconstruction
Arch Facial Plast Surg
(2004) Irradiated homologous costal cartilage for augmentation rhinoplasty
Ann Plast Surg
(1990)
Cited by (30)
“An integrated clip-shaped costal cartilage carving approach for rhinoplasty”
2022, Journal of Plastic, Reconstructive and Aesthetic SurgeryCitation Excerpt :Additionally, warping is more obvious when costal cartilage is cut into several pieces for grafting.10 To overcome these drawbacks, it is best to carve from the central core of the rib into one en-bloc graft to minimize the effect of warping.11 Clip-shaped costal cartilage grafts provide an adequate framework that incorporates the properties of the septal extension graft and columellar struts to support the nasal tip.
Costal Cartilage Harvest
2022, Rhinoplasty: A Case-Based ApproachRecent advances in bioprinting technologies for engineering different cartilage-based tissues
2021, Materials Science and Engineering CCitation Excerpt :Moreover, CC represents an attractive and valuable source for grafting. As a matter of a fact, CC grafts are commonly used in craniofacial surgeries for mandibular reconstruction, in rhinoplasty, in tracheoplasty as a stent graft, and for auricular reconstruction [99–103]. However, to the best of our knowledge, no research study regarding CC tissue engineering or bioprinted CC scaffolds can be found in literature, thus highlighting the need to explore this CTE field of study.
Primary Rhinoplasty
2016, Facial Plastic Surgery Clinics of North AmericaCitation Excerpt :As with all aspects of surgery, the application of these principles should be individualized and applied with sound judgment. The rib is frequently used as a graft donor site for aesthetic and corrective rhinoplasty.31 Even in the situation of a primary rhinoplasty, there may be inadequate septal cartilage available to do the necessary grafting.
Experience harvesting costal cartilage under IV sedation
2020, American Journal of Otolaryngology - Head and Neck Medicine and SurgeryCitation Excerpt :Although a degree of debate exists on the ideal grafting material, autologous cartilage grafts are favored for their superior characteristics and their use seems to be increasing in frequency [1,2]. While numerous techniques for costal cartilage harvesting have been described, one consistency in the published literature is that the procedure is performed under general anesthesia [3,4]. In fact, it has generally been accepted dogma that costal cartilage harvest should always be done under general inhalational anesthesia [5].
No pertinent disclosures.