Outcome of Free Diced Cartilage Grafts in Rhinoplasty: A Systematic Review

Ledo TO, Ramos HHA, Buba CM, Webster G, de Lima JT Jr, de Paiva DL, Jurado J.

What this paper says

Across six studies covering 4,044 rhinoplasty patients given free diced cartilage grafts, 61 patients, 1.51 percent, needed a further operation, mainly for overcorrection or bridge irregularities.

Overview

Diced cartilage is cartilage cut into small pieces so it can be molded to the contour of the nose, offering easier shaping than a solid block. Any graft can still become visible, distort or be absorbed. This systematic review assessed outcomes of free diced cartilage, meaning diced cartilage placed without a wrapping. The authors searched PubMed, Lilacs, Scielo and Cochrane for diced cartilage and rhinoplasty, then applied inclusion and exclusion criteria.

Sections of note

Systematic review; six eligible studies were included.
A total of 4,044 patients underwent rhinoplasty with a free diced cartilage graft.
Sixty one patients, 1.51 percent, required reoperation.
The main reasons for reoperation were overcorrection and irregularities of the nasal dorsum.
Infection was reported in three studies, with 2 infections at the graft site among 3,252 patients, 0.06 percent.
Two cases of graft displacement were treated with external molding rather than surgery.
Graft resorption was reported in four studies, with 22 cases of partial resorption among 3,288 patients, 0.67 percent.
The authors conclude resorption and unfavorable outcomes are rare.

What it means for a patient

Diced cartilage placed on the bridge failed rarely in the pooled data, with about one patient in 66 needing a second operation.
The commonest problem was too much height or a visible irregularity, not loss of the graft.
The included studies were not randomized trials, and the review pooled results across different surgeons and techniques.
Denominators differ by outcome because not every study reported infection or resorption, so the rates are not all drawn from the same patients.

Why this paper matters

Diced cartilage is now a standard way to raise and smooth the nasal bridge, and the long standing objection to it has been that the pieces resorb. This review assembles the largest available count against that objection. How long these patients were followed, and how consistently resorption was assessed, is not stated in the abstract.

Terms

Diced cartilage: cartilage cut into small fragments that can be shaped like a paste.
Free diced cartilage: diced cartilage placed without a fascia or other wrapping.
Block graft: a single solid piece of cartilage.
Resorption: gradual absorption and loss of graft material by the body.
Overcorrection: a result with more height or volume than intended.
Systematic review: a structured search and pooling of all studies meeting set criteria.

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

From the abstract

“Diced cartilage grafts are used to increase and refine the nasal contour, providing easy molding and versatility when compared with block grafts. However, all grafts present the possibility of visibility, distortion, and absorption. The aim of this study is to evaluate, through a systematic review, the outcome of the…”

Excerpt; the full abstract is on PubMed.