Lollipop-Like Costal Cartilage Graft with a Peach-Shaped Head for East Asian Rhinoplasty

Jin C, Wu Q, Yin A, Chen J, Liu H, Mu S, Zhang X.

PubMed 38233685 Publisher (DOI)Free full text (PMC)

What this paper says

In 31 Chinese patients given a rib cartilage tip graft shaped like a lollipop with a rounded head, 90.3 percent were satisfied and appearance scores rose from 3.97 to 7.39 over a mean 17 month follow up.

Overview

Refining the tip is the hardest part of East Asian rhinoplasty because the native cartilage is weak and the skin is thick. Rib cartilage from the patient is commonly used for tip support. The authors describe a modified graft carved with a stem and a rounded head, and retrospectively reviewed patients who received it in primary rhinoplasty between November 2018 and March 2021.

Sections of note

Design: retrospective cohort study, 31 adult patients, single centre. Level of evidence IV.
Mean follow up: 17.12 months, standard deviation 3.89.
Graft material: the patient's own costal cartilage.
28 of 31 patients, 90.3 percent, were satisfied with the aesthetic outcome.
Mean visual analog score rose from 3.97 to 7.39, p less than 0.01.
Mean Rhinoplasty Outcome Evaluation score rose from 11.77 to 17.22, p less than 0.01.
Photogrammetric analysis showed significant improvements in nasal measurements.
Among the three dissatisfied patients, two had mild columella deviation and one had mild bridge deviation. No other notable complications were reported.

What it means for a patient

The shape of the graft is the point: a stem for support with a rounded head to give the tip a soft contour under thick skin.
Roughly one in ten patients was dissatisfied, and in each case the problem was a mild deviation rather than a failure of the graft.
Using the patient's own rib means a chest incision and a second surgical site, which the abstract does not discuss.
Limits: 31 patients, retrospective, single centre, no comparison group, and follow up averaging under 18 months.

Why this paper matters

Tip support in thick skinned noses requires a graft strong enough to project through the skin without producing a hard visible edge, and graft shape is where surgeons differ. Documenting a specific carved shape with outcome scores adds to that catalogue. Whether it outperforms other tip graft designs is untested.

Terms

Costal cartilage: cartilage from the ribs, harvested for use as a graft.
Autologous: taken from the patient's own body.
Nasal tip refinement: reshaping the tip to make it narrower or better defined.
Visual analog scale: a line on which severity or quality is marked.
Rhinoplasty Outcome Evaluation: a patient questionnaire scoring satisfaction with the nose.
Photogrammetric analysis: measurement of distances and angles from standardized photographs.

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

Abstract

Background: Nasal tip refinement is a challenging step of East Asian rhinoplasty due to complex anatomical defects. Autologous costal cartilage grafts are commonly used to provide nasal tip support. This study aims to evaluate the efficacy and safety of a modified technique using a lollipop-like cartilage graft with a peach-shaped head.

Methods: A retrospective review was conducted on Chinese patients who underwent primary rhinoplasty with the modified technique between November 2018 and March 2021 at our center. Preoperative and postoperative facial photographs, patient-reported outcome measures including the visual analog scale (VAS) and the rhinoplasty outcome evaluation (ROE), as well as surgery-related complications, were collected for outcome assessment.

Results: A total of 31 adult patients were included in this retrospective cohort study, with a mean follow-up period of 17.12 ± 3.89 months. The majority of patients (28/31; 90.3%) expressed satisfaction with the aesthetic outcomes, as evidenced by a significant increase in mean VAS score from 3.97 ± 1.52 preoperatively to 7.39 ± 0.22 postoperatively (P < 0.01), and a significant increase in mean ROE score from 11.77 ± 2.33 to 17.22 ± 2.47 (P < 0.01). Photogrammetric analysis also demonstrated significant improvements in nasal anatomical measurements. Among the three patients with unsatisfactory feedback, two had mild columella deviations and one had a mild dorsum deviation. No other notable complications were reported.

Conclusion: The current study supports the safety and utility of the modified technique utilizing the lollipop-like costal cartilage graft with a peach-shaped head for major tip refinement in East Asian patients.

Level Of Evidence Iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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