Imaging Studies

Imaging studies are generally not necessary. However, some authors have recommended limited preoperative computed tomographic scans of the sternum and ribs in elderly patients undergoing costal cartilage harvest. Experienced radiologists can determine the extent of calcification in the cartilaginous rib. Significant ossification may warrant the selection of alternative grafting material.

Treatment & Management

Park SS. Fundamental principles in aesthetic rhinoplasty. Clin Exp Otorhinolaryngol. 2011 Jun. 4(2):55-66. [Medline]. [Full Text].
Bohluli B, Varedi P, Bagheri SC, Rezazade M. Nasal radix augmentation in rhinoplasty: suggestion of an algorithm. Int J Oral Maxillofac Surg. 2017 Jan. 46 (1):41-5. [Medline].
Yang CE, Kim SJ, Kim JH, Lee JH, Roh TS, Lee WJ. Usefulness of Cross-Linked Human Acellular Dermal Matrix as an Implant for Dorsal Augmentation in Rhinoplasty. Aesthetic Plast Surg. 2018 Feb. 42 (1):288-94. [Medline].
Wee JH, Park MH, Oh S, Jin HR. Complications associated with autologous rib cartilage use in rhinoplasty: a meta-analysis. JAMA Facial Plast Surg. 2015 Jan-Feb. 17 (1):49-55. [Medline].
Kim KK, Zhao L, Belafsky P, Patel PK, Strong EB. Technical note: "look-ahead" navigation method for K-wire fixation in rhinoplasty. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 Feb. 105(2):168-72. [Medline].
Shipchandler TZ, Chung BJ, Alam DS. Saddle nose deformity reconstruction with a split calvarial bone L-shaped strut. Arch Facial Plast Surg. 2008 Sep-Oct. 10(5):305-11. [Medline].
Daniel RK. Diced cartilage grafts in rhinoplasty surgery: current techniques and applications. Plast Reconstr Surg. 2008 Dec. 122(6):1883-91. [Medline].
Tosun Z, Karabekmez FE, Keskin M, Duymaz A, Savaci N. Allogenous cartilage graft versus autogenous cartilage graft in augmentation rhinoplasty: a decade of clinical experience. Aesthetic Plast Surg. 2008 Mar. 32(2):252-60; discussion 261. [Medline].
Deva AK, Merten S, Chang L. Silicone in nasal augmentation rhinoplasty: a decade of clinical experience. Plast Reconstr Surg. 1998 Sep. 102(4):1230-7. [Medline].
Yap EC, Abubakar SS, Olveda MB. Expanded polytetrafluoroethylene as dorsal augmentation material in rhinoplasty on Southeast Asian noses: three-year experience. Arch Facial Plast Surg. 2011 Jul-Aug. 13(4):234-8. [Medline].
Gao F, Yin NB, Ji Y, Song T, Li HD. Alar cartilage used as tip grafts in secondary silicone augmentation rhinoplasty in Chinese patients. J Craniofac Surg. 2011 Mar. 22(2):614-6. [Medline].
Godin MS, Waldman SR, Johnson CM Jr. Nasal augmentation using Gore-Tex. A 10-year experience. Arch Facial Plast Surg. 1999 Apr-Jun. 1(2):118-21; discussion 122. [Medline].
Qian SY, Malata CM. Avoiding pitfalls in open augmentation rhinoplasty with autologous L-shaped costal cartilage strut grafts for saddle nose collapse due to autoimmune disease: the Cambridge experience. J Plast Reconstr Aesthet Surg. 2014 Aug. 67 (8):e195-203. [Medline].
Marin VP, Landecker A, Gunter JP. Harvesting rib cartilage grafts for secondary rhinoplasty. Plast Reconstr Surg. 2008 Apr. 121(4):1442-8. [Medline].

Media Gallery

Young boy with bilateral cleft lip and palate who also has midface hypoplasia and requires nasal augmentation.
Young boy (same patient as in the image above) with bilateral cleft lip and palate who also had midface hypoplasia and required nasal augmentation, shown after dorsal nasal augmentation was accomplished using autologous rib grafts. It was fashioned slightly larger than needed to account for the patient's future facial growth.
Woman with a subtype of midline granulomatous disease that caused nasal collapse. Augmentation was required.
Woman (same patient as in image above) with a subtype of midline granulomatous disease that caused nasal collapse, shown after augmentation with both autologous rib and cartilage grafts. AlloDerm was also used for additional augmentation.

of 4

Author

Eugene A Chu, MD Clinical Instructor, Division of Rhinology, Johns Hopkins Department of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Patrick Byrne, MD Associate Professor, Department of Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine

Patrick Byrne, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate-Craniofacial Association, American College of Surgeons

Disclosure: Nothing to disclose.

Peter Hilger, MD, MS, FACS Professor, Department of Otolaryngology, University of Minnesota Medical School

Peter Hilger, MD, MS, FACS is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, Minnesota Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Dean Toriumi, MD Associate Professor, Department of Otolaryngology, University of Illinois Medical Center

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cerescan;RxRevu;Cliexa;The Physicians Edge;Sync-n-Scale;mCharts<br/>Received income in an amount equal to or greater than $250 from: The Physicians Edge, Cliexa;Proforma;Neosoma<br/> Received stock from RxRevu; Received ownership interest from Cerescan for consulting; .

Additional Contributors

Richard V Smith, MD Director of Clinical Affairs, Associate Professor, Department of Otolaryngology, Division of Head and Neck Surgery, Einstein College of Medicine, Montefiore Medical Center

Richard V Smith, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Head and Neck Society, The Triological Society, American Medical Association, American Medical Student Association/Foundation, Medical Society of the District of Columbia, New York Academy of Medicine, Vermont Medical Society

Disclosure: Nothing to disclose.

	Advantages	Disadvantages
Septum	Easy harvest Present in the surgical field (no separate donor-site morbidity) Straight (good for certain purposes, such as a columellar strut)	May be deficient Straight (less desirable as batten graft)
Auricle	Easy harvest Relatively abundant Curved nature ideal for certain purposes	Separate donor site Curved (less desirable for some purposes)
Rib	Large volume (abundant, even for significant augmentation) Distant donor site (2-team approach possible) Reliable	Donor-site morbidity Warping possible

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