Asian Rhinoplasty Using Exclusively Auricular Cartilage Through a Closed Approach

Gu Q, Fu Z, Li J, Yan S, Wu S, Sun Y.

PubMed 41411306 Publisher (DOI)

What this paper says

In 63 Asian patients, a closed-approach rhinoplasty using only ear cartilage for the tip framework and diced ear cartilage for the bridge produced measurable improvement in every aesthetic index and higher satisfaction at 12 months.

Overview

Open rhinoplasty risks a visible columellar scar and synthetic implants risk infection, so the authors from Zhejiang Provincial People's Hospital designed a technique using neither. Between October 2022 and June 2024, patients had incisions inside both nostrils; a strut, septal extension graft and tip grafts were built from ear cartilage, and the dorsum was filled with diced ear cartilage. Aesthetic indices were measured in Photoshop before surgery and at 12 months.

Sections of note

63 patients aged 18 to 45 (mean 25.6).
All measured aesthetic indices improved significantly (P < .05).
VAS and ROE satisfaction scores improved significantly (P < .05).
3D imaging showed nasal volume increased by a mean 2.9 mL; volume did not change between 6 and 12 months (P > .05), indicating the graft did not shrink over that interval.
Level of Evidence 4.

What it means for a patient

Augmentation without a silicone implant, without a rib harvest and without an external scar is possible using ear cartilage alone.
In this series the added volume was stable from 6 to 12 months.
Ear cartilage is limited in quantity and is softer than rib, which may restrict how much augmentation it can provide; the study does not address larger augmentations.

Why this paper matters

It presents an all-autologous, all-closed alternative to the implant-based augmentation common in East Asia. Limits: single centre, 12-month follow-up, no comparison group.

Terms

Auricular (conchal) cartilage: cartilage from the bowl of the ear.
Diced cartilage: cartilage cut into small pieces so it can be moulded.
Septal extension graft: cartilage fixed to the septum to lengthen or project the tip.
VAS: visual analogue scale, a 0-10 satisfaction line.
ROE: Rhinoplasty Outcome Evaluation, a satisfaction questionnaire.

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

From the abstract

“In rhinoplasty, the open approach carries potential risks such as hypertrophic scarring, whereas synthetic implants carry potential risks like infection. Therefore, we propose a new technique that utilizes exclusively auricular cartilage for both framework construction and dorsal augmentation through closed approach.…”

Excerpt; the full abstract is on PubMed.