Background: Modern techniques in structure rhinoplasty require cartilage for grafting. The optimal source of this cartilage is debated. Fresh frozen homologous costal cartilage (FFHCC) grafts are a promising source of cartilage; further investigation is needed into efficacy and safety. The purpose of this article is to review an extensive rhinoplasty experience using FFHCC in cosmetic and functional applications.
Methods: Retrospective review of one surgeon's experience performing 123 rhinoplasties using FFHCC grafts was performed. Outcomes were postoperative complications and patient-reported outcome measures (PROMs).
Results: The average follow-up time was 11.0 months (range, 1 to 44 months). Infection was noted in 3 patients (2.4%). Resorption was noted in 1 patient (0.8%). Analysis of PROMs was at last follow-up. Nasal Obstruction Symptom Evaluation scores showed mean improvement of -7.9 ± 8.1 ( P < 0.001). Twenty-Two Item Sinonasal Outcomes Test scores showed mean improvement of -18.9 ± 17.5 ( P < 0.001). Epworth Sleepiness Scale scores showed mean improvement of -4.8 ± 5.8 ( P < 0.001). The Standardized Cosmesis and Health Nasal Outcomes Survey revealed total, functional, and cosmetic scores with a mean improvement of -13.5 ± 11.1 ( P < 0.001), -5.1 ± 5.9 ( P < 0.001), -8.2 ± 7.3 ( P < 0.001).
Conclusions: FFHCC grafts provide a convenient and economical off-the-shelf solution for rhinoplasty. The findings of this study support the safety of FFHCC use and demonstrate positive improvement in PROMs across multiple domains.
Copyright © 2025 by the American Society of Plastic Surgeons.