A Canadian Experience With Off-the-Shelf, Aseptically Processed, Costal Cartilage Segment Allografts in Complex Rhinoplasty

Aesthet Surg J Open Forum. 2022 Nov 22:4:ojac085. doi: 10.1093/asjof/ojac085. eCollection 2022.

Abstract

Background: Complex primary and secondary rhinoplasties usually necessitate grafting materials when native nasal cartilage is inadequate for reconstruction. Fresh frozen, aseptically processed, and nonterminally sterilized costal cartilage segment allografts (CCSAs) are a novel grafting material for such cases that avoid donor-site morbidity, improve operating efficiency, and mitigate the postoperative risks.

Objectives: To report the early experience using fresh frozen, aseptically processed, and nonterminally sterilized CCSAs used in complex primary and secondary rhinoplasties, in Canada.

Methods: We retrospectively reviewed 21 patients (17 female and 4 male patients) who underwent a primary or secondary rhinoplasty surgery using CCSAs from June 2019 to April 2022.

Results: The mean age was 39 years (range, 27-58 years), and the mean body mass index was 23.7 kg/m2 (range, 24-40 kg/m2). Of the 21 procedures, 11 were primary (52.4%) and 10 were secondary (47.6%) rhinoplasties. The mean operative time was 185 min (range, 85-330 min), with a mean follow-up time of 15.0 months (range, 2.0-37.8 months). At follow-up, 19 patients (90.5%) reported being "very satisfied" with their aesthetic results, and only 2 (9.5%) underwent revision surgery. No serious complications were reported, and only 1 case showed evidence of graft resorption.

Conclusions: Based on early experience, this CCSA avoids donor-site morbidity and reduces operative time while maintaining a low complication rate, providing a viable alternative to the use of autologous costal cartilage when indicated in complex primary or secondary rhinoplasties with inadequate native nasal cartilage.