The Use of Costal Cartilage in Rhinoplasty

Fedok FG, Lee Peng G, Tastan E, Robotti E.

What this paper says

A review stating that rib cartilage can be harvested safely through a small hidden incision and, if carved early and soaked in saline, reveals any tendency to bend before it is implanted.

Overview

Rib supplies a large quantity of the patient's own cartilage when the septum cannot. The article covers when it is needed, how it is harvested and how it is prepared. Its central practical point concerns warping: if the cartilage is carved at the start of the operation and left soaking, any bending will show while there is still time to adjust.

Sections of note

Article type: narrative review. No patient numbers, complication rates or outcome data are reported.
Harvest is described as easy and safe, through a small well hidden incision.
Indication one: primary rhinoplasty where there is not enough septal cartilage.
Indication two: revision surgery where the septal cartilage was previously used or removed.
Preparation: carve the rib cartilage on a cutting board before the rhinoplasty begins.
Rationale: soaking in saline during the operation allows any warping to appear before the graft is placed.
Stated summary: autologous rib is a good source of copious and often good quality cartilage.

What it means for a patient

Rib is used when the septum cannot supply enough material, most often in revision surgery or in noses needing substantial support.
The harvest leaves a chest scar, which the article describes as small and hidden but which is a second surgical site.
Warping is the recognized problem with rib, and carving early is a practical way to detect it before it is built into the nose.
The abstract carries no findings. It reports no complication rates, warping rates or outcomes.

Why this paper matters

The choice between rib, ear, banked donor cartilage and synthetic material is one of the consequential decisions in complex rhinoplasty, and each carries its own failure mode. Practical guidance on timing the carving addresses warping, the main objection to rib. How often warping still occurs despite this precaution is not stated.

Terms

Costal cartilage: cartilage from the ribs, harvested for use as a graft.
Autologous: taken from the patient's own body.
Warping: bending or curling of a cartilage graft after it is carved.
Septal cartilage: the cartilage of the wall dividing the two sides of the nose.
Revision rhinoplasty: a further operation to correct the result of an earlier one.

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

From the abstract

“Autologous cartilage can be easily and safely harvested as a reliable source of cartilage in rhinoplasty through a small, well-hidden incision. Rib cartilage can be utilized during a primary rhinoplasty when there is insufficient cartilage from the septum or often in revisional nasal surgeries where the initial septal…”

Excerpt; the full abstract is on PubMed.