APS Aesthetic Plastic Surgery · 2026

Introducing "Papyrus Graft": A Versatile and Reliable Backup in Challenging Structural Rhinoplasty

Agrawal KS, Mathur P, Kathare P, Mehta V, Gaurav S, Francis J, Krishna V, Gauri S, Mewada S, Acharya M, Patel S, Swami P, Girija HR, Chaturvedi S, Deshmukh P, Rishikesh V, Sam S, Mago R, Shende N, Chalwade C, Puri V.

PubMed 40877600 Publisher (DOI)

What this paper says

In 18 structural rhinoplasty patients whose rib cartilage proved calcified, brittle or too small, a graft the authors call the "Papyrus graft" achieved the intended shape and support with no major complications.

Overview

When septal and ear cartilage are used up, rib is the fallback, but harvested rib can be ossified, brittle or insufficient. The Indian authors describe the Papyrus graft as a solution for these situations and retrospectively reviewed patients treated with it between 2018 and 2024, recording demographics, graft survival, outcomes and complications. The abstract does not state what the graft is made of or how it is constructed.

Sections of note

18 patients: 13 women, 5 men; mean age 29.8.
Indication: revision or secondary rhinoplasty with exhausted septal and conchal cartilage and unusable rib.
Reported results: high success in achieving nasal shape and structural integrity, significant improvement in shape and satisfaction.
No major complications.
Level of Evidence IV.

What it means for a patient

Surgeons have options when even rib cartilage fails; this paper reports one, but the abstract does not explain what it is.
Eighteen patients with unquantified outcomes is early evidence.
Its main value is for patients with multiple prior operations.

Why this paper matters

It addresses a real problem, unusable rib cartilage in revision surgery, though the abstract withholds the technique's substance. Limits: 18 patients, retrospective, no outcome scores, graft composition not described in the abstract.

Terms

Structural rhinoplasty: rebuilding the nasal framework with grafts.
Ossification: conversion of cartilage to bone, making it unusable for carving.
Conchal cartilage: cartilage from the ear bowl.
Secondary rhinoplasty: a repeat operation.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Structural rhinoplasty is a complex surgical procedure that aims to restore and enhance nasal structure and function by reconstructing the underlying framework. Robust grafting material is required for durable results. For revision or secondary rhinoplasty cases where septal and conchal cartilage reserves are…”

Excerpt; the full abstract is on PubMed.