Autologous rib cartilage use in rhinoplasty associated with low rates of overall long-term complications

Using a patient's own rib cartilage (autologous) for rhinoplasty appears to be associated with low rates of overall long-term complications and problems at the rib site where the cartilage is removed, according to a report published online by JAMA Facial Plastic Surgery.

Autologous rib cartilage is the preferred source of graft material for rhinoplasty because of its strength and ample volume. However, using rib cartilage for dorsal augmentation to build up the bridge of the nose has been criticized for its tendency to warp and issues at the cartilage donor site, such as pneumothorax (a collapsed lung) and postoperative scarring.

Jee Hye Wee, M.D., of the National Medical Center, Seoul, South Korea, and co-authors reviewed the available medical literature to evaluate complications associated with autologous rib cartilage and rhinoplasty.

Authors identified 10 studies involving 491 patients with an average follow-up across all studies of 33.3 moths. Results indicate that combined complication rates from the studies were 3.08 percent for warping, 0.22 percent for resorption, 0.56 percent for infection, 0.39 percent for displacement, 5.45 percent for hypertrophic chest scarring (keloids), 0 percent for pneumothorax and 14.07 percent for revision surgery.

"The overall long-term complications associated with autologous rib cartilage use in rhinoplasty were low. Because warping and hypertrophic chest scarring had relatively high rates, surgeons should pay more attention to reduce these complications. ... Future analysis should include studies with larger pools of patients, clearer definitions of complications and longer-term follow-up to obtain more reliable results," the study concludes.

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