A novel technique for sculpting costal cartilage in microtia repair and rhinoplasty

Lee LN, Boahene KD.

What this paper says

The authors describe carving rib cartilage for ear reconstruction and rhinoplasty with disposable skin punch biopsy tools, which are cheap, always sharp and come in many sizes, and report excellent results without giving patient numbers.

Overview

Turning a block of rib cartilage into an ear framework or a nasal bridge means cutting many small curves and hollows. Specialized curved blades exist for this but have drawbacks. The authors adapted the round, disposable punch used for skin biopsies as a cartilage carving tool and describe how it is used.

Sections of note

Surgical technique description from an academic tertiary care center; level of evidence not applicable.
Problem: specialized carving instruments bring several challenges, and excessive force with dull blades can damage the framework.
Tool: commercially available disposable skin punch biopsy instruments.
Stated advantages: lower cost, consistently sharp blades, a range of sizes for precise, controlled contour changes.
Applied in microtia repair and rhinoplasty requiring rib cartilage sculpting.
Outcome reported only as "excellent results"; no counts, follow-up or complications.

What it means for a patient

The shaping of a rib graft depends on the surgeon's tools as well as skill, and this paper offers a simple, sharp option.
The abstract gives no evidence that grafts carved this way perform better or warp less.
It is a technical tip for surgeons rather than a study of patient outcomes.

Why this paper matters

Rib cartilage carving is labor-intensive and precision affects graft fit and warping. Inexpensive disposable tools lower the barrier for surgeons without specialized instrument sets. Whether the method changes results is untested in the abstract.

Terms

Costal cartilage: cartilage from the rib, used as a graft.
Microtia: a birth condition in which the outer ear is small or absent, repaired with a carved rib cartilage framework.
Skin punch biopsy instrument: a disposable round blade normally used to remove a small core of skin for testing.
Sculpting: carving cartilage into the curves and hollows of the desired shape.
Framework: the carved cartilage skeleton that gives an ear or nasal bridge its shape.
Armamentarium: the set of tools and techniques available to a surgeon.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Transforming a block of costal cartilage into a complex 3-dimensional framework that reflects the contours of a normal ear or nasal bridge requires the creation of many subtle curves, concavities, and convexities. Thus, specialized instruments for microtia repair and rhinoplasty, with specifically curved sharp blades,…”

Excerpt; the full abstract is on PubMed.