The Utilization of Fresh Frozen Cartilage in Asian Rhinoplasty: A New Approach

Wan R, Weissman JP, Ullrich PJ, Joshi C, Williams T, Galiano RD.

PubMed 37124386 Publisher (DOI)Free full text (PMC)

What this paper says

Five Asian patients had their noses augmented with fresh frozen donor cartilage and, over an average of 14.2 months, showed no resorption, warping or infection, with satisfaction with the nose rising from 35.2 to 60 on the FACE-Q.

Overview

Asian rhinoplasty usually adds volume rather than removing it. Synthetic implants carry higher complication rates, and the patient's own cartilage is safer but often insufficient, since Asian patients frequently lack enough septal cartilage and harvesting rib or ear cartilage adds operating time, donor site problems, warping and infection risk. The senior author used fresh frozen cadaveric cartilage instead, and measured results on photographs and questionnaires.

Sections of note

Design: case series of five patients, single senior surgeon.
Mean follow up: 14.2 months, standard deviation 3.35.
Photographic measures taken: nasofrontal angle, nasofacial angle, nasolabial angle and Goode ratio.
No resorption, warping or infection occurred in any patient.
Photographic measurements showed no significant change at 2 to 4 months or at 8 to 20 months after surgery.
FACE-Q Satisfaction with Nose rose from 35.2 to 60, p equal to 0.0002.
FACE-Q Satisfaction with Nostrils rose from 42.6 to 59.8, but this did not reach significance, p equal to 0.12.

What it means for a patient

Donor cartilage that has been frozen rather than processed avoids both a rib incision and a synthetic implant.
No shrinkage or bending was seen within roughly a year, which are the two failure modes surgeons watch for with any cartilage graft.
Satisfaction with the nose improved significantly. Satisfaction with the nostrils did not, and its standard deviation was wide.
Limits are severe: five patients, no comparison group, one surgeon, and follow up averaging just over a year. Five patients cannot establish an infection rate for donor tissue.

Why this paper matters

Finding enough graft material without creating a second surgical site is the central supply problem in augmentation rhinoplasty. Banked donor cartilage would solve it if it survives without resorbing. This series is far too small to establish safety, and longer follow up is needed since resorption of donor cartilage typically shows over years, not months.

Terms

Augmentation rhinoplasty: surgery that adds height or projection to the nose.
Alloplastic graft: an implant made of synthetic material.
Autologous cartilage: cartilage taken from the patient's own body.
Fresh frozen cartilage: donor cartilage preserved by freezing rather than chemical processing.
Warping: bending or curling of a cartilage graft after placement.
Goode ratio: a photographic measure of how far the nasal tip projects relative to nasal length.

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

Abstract

Asian rhinoplasty generally requires augmentation procedures rather than reduction. Alloplastic grafts are fraught with higher complication rates. Autologous cartilage grafts are safer. However, Asian patients typically do not have adequate septal cartilages, and other autologous cartilage grafts may cause surgical site morbidities, prolonged surgical time, and complications, including warping and infection. Asian rhinoplasties were performed using fresh frozen cartilage by the senior author. Patients' demographics and medical histories were recorded. Anthropometric measurements (nasofrontal angle, nasofacial angle, nasolabial angle, and Goode ratio) were taken on two-dimensional photographs. FACE-Q scales were used to assess patient-reported outcomes. Five Asian patients underwent rhinoplasty using the fresh frozen cartilage and were followed up for an average period of 14.2 ± 3.35 months. There was no resorption, warping, or infection. Anthropometric measurements showed no significant changes 2-4 months or 8-20 months after surgery. At the time of the 1-year follow-up, mean FACE-Q Satisfaction with Nose, and Satisfaction with Nostrils scores improved from 35.2 ± 10.06 to 60 ± 15.48 (P = 0.0002), and 42.6 ± 20.31 to 59.8 ± 38.21 (P = 0.12), respectively. Fresh frozen cadaveric cartilage is a novel option for Asian rhinoplasty. Our study demonstrated its safety and satisfying surgical outcomes.

Abstract as indexed by PubMed; the article is open access (PubMed Central).