The 10th Costal Cartilage Graft in Secondary Cleft Rhinoplasty-A Versatile Rib

Ujam AB, Vig N, Nasser N.

PubMed 36100245 Publisher (DOI)

What this paper says

A technique article advocating the tenth rib cartilage as a graft source in secondary cleft rhinoplasty, which the authors state is easy to harvest and gives predictable results with few complications.

Overview

Rib cartilage from the patient's own body provides both the volume and the quality needed for nasal reconstruction. The fifth through eighth rib cartilages are commonly harvested while the tenth is often overlooked, though the authors state it works well for columellar, nostril rim, tip and bridge grafts. Its use in complex secondary cleft nasal deformity has scant coverage in the literature.

Sections of note

Technique article with illustrative clinical cases; the abstract reports no patient numbers, no rates and no defined follow up period.
Commonly harvested ribs are the fifth, sixth, seventh and eighth.
The tenth rib is described as suitable for columellar, alar rim, nasal tip and bridge augmentation grafts.
The authors demonstrate what they describe as a simple and quick harvesting technique.
Long term results are said to show ease of harvest, stability and predictable outcomes.
Several clinical cases are presented.
The senior author reports using the graft in a variety of challenging secondary cleft procedures.
The authors advocate its use, citing ease of harvest and low complication levels.

What it means for a patient

The tenth rib is lower on the chest wall than the ribs usually used, which affects where the scar sits.
The graft is used for smaller structural pieces rather than large bridge blocks.
No complication rates, patient numbers or measured outcomes are reported.
Claims of stability and predictability rest on the author's experience with selected cases.

Why this paper matters

Secondary cleft rhinoplasty needs substantial graft material and the usual rib sites may already have been used. This article documents an additional source. Without reported numbers its advantages over the conventional ribs are unestablished.

Terms

Costal cartilage: cartilage from the rib.
Secondary cleft rhinoplasty: nasal surgery after the initial cleft repair in infancy.
Columellar graft: cartilage supporting the strip between the nostrils.
Alar rim graft: a strip of cartilage supporting the nostril edge.
Dorsal augmentation: raising the height of the nasal bridge.

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

From the abstract

“Autologous costal cartilage for rhinoplasty is an excellent graft material providing both volume and quality of cartilage required for nasal reconstruction. Commonly, the 5th, 6th, 7th, and 8th rib costal cartilages have been harvested but other ribs such as the 10th rib are often overlooked and yet offer an excellent…”

Excerpt; the full abstract is on PubMed.