Asian rhinoplasty using a thin rib cartilage graft and ultrafine diced cartilage wrapped in fascia: A comparative study between septal cartilage graft and rib cartilage graft

  • Hojin Park
    Department of Plastic and Reconstructive Surgery, Korea University, College of Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
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  • Yeongsong Kim
    Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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  • Jong Woo Choi
    Corresponding author: Jong-Woo Choi, MD, PhD, MMM, Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2dong Songpa-gu, Seoul 138-736, Korea, Phone: 82-2-3010-3604, Fax: 82-2-476-7471
    Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Published:November 21, 2022DOI:


      Background: A 1–2-mm thin rib cartilage graft was used as a septal extension graft to overcome the pitfalls of traditional rib cartilage rhinoplasty, which often results in a stiff nasal tip. The remaining rib cartilage was placed on the nasal dorsum as an ultrafine diced cartilage wrapped in fascia (UDCWF) graft. This study aimed to assess the stability of thin rib cartilage grafts and to measure the resorption rate of the UDCWF graft.
      Methods: This retrospective study included 53 patients who underwent rhinoplasty with septal extension grafting and nasal dorsum augmentation using a septal cartilage (SC group) or rib cartilage (RC group) graft between June 2017 and June 2020. The nasal length, tip height, sellion height, and nasolabial angle in the preoperative, immediate postoperative, and long-term postoperative periods were analyzed using three-dimensional photogrammetry.
      Results: Of the patients, 26 received rib cartilage grafts and 27 patients received septal cartilage grafts. The RC group showed greater maintenance of tip height, nasal length, and tip de-rotation over time. The relapse ratio in tip height was -3.3±1.6% and -8.4±4.3% in the RC and SC groups, respectively (p=0.001). The resorption rate of the UDCWF graft was -7.5±3.6% and -7.8±2.3% at the sellion and rhinion, respectively.
      Conclusions: The thin rib cartilage provided sufficient intrinsic strength to maintain tip height and tip rotation. It can be an effective alternative for rhinoplasty in Asians with features such as thick skin and a short nose. Moreover, the UDCWF graft exhibited an approximately 7.5% resorption rate, leading to lower probabilities of dorsal irregularity and stepping deformity.


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