Autologous costal cartilage for nasal tip surgery: report of 86 cases

Objective To present our experience and techniques with the use of autologous costal cartilage grafts in Asian rhinoplasty, and to report the surgical results and complications in 86 consecutive rhinoplasty cases. Methods All operations were performed by the first author (Liu AT) with open approach, costal cartilages and perichondrium were used to reconstruct the nasal tip projection according to the tripod theory in rhinoplasty, after removing the previous injection material, L-shaped implant or hypertrophic scar tissue in the tip. Medical charts and operative records were reviewed retrospectively to summary the complications. Nasal dorsum augmentation was done by costal cartilage or I-shaped allograft, sometimes with anterior sheath of rectus abdominis. Patients＇ subjective satisfaction of the postoperative nasal appearance was self-evaluated with grading (1 worse, 2 no change, 3 improved, and 4 much improved). Results From September 2015 to March 2017, 86 patients underwent rhinoplasty at our hospital. The postoperative follow-up duration was 6 to 20 months. Overall, functional and aesthetic outcome was satisfactory in most patients, and the mean score by the patients＇ self-evaluation was 3.3±0.6. Graft exposure, mobility, or significant resorption, pneumothorax or significant donor-site pain were not observed. Conclusions Even with minimal complications and morbidities, autologous costal cartilage grafts in Asian rhinoplasty is a versatile and reliable graft material for nasal tip surgery in severe short or saddle nose, contracted nose due to previous L-shaped augmentation and revision rhinoplasty in which the septal cartilage has already been harvested. Key words: Autologous costal cartilage; Nasal tip plasty; Nasal dorsum augmentation; Revision rhinoplasty; Saddle nose