Cartilage Grafting Techniques in Rhinoplasty

The restoration and refinement of nasal form and function through cartilage grafting has long been a cornerstone of rhinoplasty. Autologous grafts derived from septal, auricular or costal cartilage remain the standard, offering biocompatibility and structural support. Septal cartilage is favoured for its flat, pliable nature in dorsal onlay and spreader grafts. Auricular cartilage provides curvature suitable for alar batten grafts yet is limited by its elastic memory. Costal cartilage yields ample volume for major augmentations but carries potential for warping and donor-site morbidity. Allogeneic materials and synthetic implants have emerged as alternatives in complex or revision cases, aiming to reduce operative time and avoid additional donor-site injury. Diced cartilage techniques permit contour refinement by packing or injecting small fragments within a wrapping material to achieve smooth dorsal augmentation. Recent innovations integrate tissue engineering, utilising membrane scaffolds and stem cells to enhance graft survival and reduce resorption. In parallel, advances in harvesting methods have minimised morbidity and improved aesthetic outcomes at donor sites. The selection of graft type and technique requires consideration of patient anatomy, desired projection, risk of warping or resorption, and long-term stability. As the field evolves, a balance is sought between the reliability of traditional autologous grafts and the potential of engineered constructs to expand surgical options.

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Cartilage Grafting Techniques in Rhinoplasty publication trend

The graph below shows the total number of articles in cartilage grafting techniques in rhinoplasty across all publications each year (not limited to Nature Index journals).

Technical terms

Autologous graft: Tissue transplanted from the patient’s own body to ensure high biocompatibility and reduce immune rejection.

Allograft: Donor tissue from another individual of the same species, used to avoid donor-site morbidity and expedite surgery.

Diced cartilage: Small fragments of cartilage packed or injected within a scaffold to allow fine contouring of the nasal dorsum.

Perichondrium: The fibrous connective tissue enveloping cartilage, often harvested to wrap diced cartilage and promote integration.

Tissue engineering membrane: Biodegradable scaffold material designed to support cell adhesion, proliferation and eventual integration of grafts.

References

1. Promotion of diced cartilage survival and regeneration with grafting of small intestinal submucosa loaded with urine‐derived stem cells. Cell Proliferation (2023).
2. Minimally Invasive Harvesting Technique for Costal Cartilage Graft: Donor Site, Morbidity and Aesthetic Outcomes. Journal of Clinical Medicine (2023).
3. A Canadian Experience With Off-the-Shelf, Aseptically Processed, Costal Cartilage Segment Allografts in Complex Rhinoplasty. Aesthetic Surgery Journal Open Forum (2022).
4. The current techniques in dorsal augmentation rhinoplasty: a comprehensive review. Maxillofacial Plastic and Reconstructive Surgery (2024).