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

Goals/Purpose: Complex primary and secondary rhinoplasties usually necessitate grafting materials when native nasal cartilage is inadequate for reconstruction. Fresh frozen, aseptically processed, and non-terminally 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. The objective of this study is to report the early experience using fresh frozen, aseptically processed, and non-terminally sterilized CCSAs used in complex primary and secondary rhinoplasties, in Canada.

Methods/Technique: s: 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/Complications: The mean age was 39 years (range, 27 to 58 years) and the mean BMI was 23.7 kg/m² (range, 24 to 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 minutes (range, 85 to 330 minutes), with a mean follow-up time of 15.0 months (range, 2.0 to 37.8 months). At follow-up, 19 patients (90.5 percent) reported being ‘very satisfied’ with their aesthetic results, and only two (9.5%) underwent revision surgery. No serious complications were reported, and only one case showed evidence of graft resorption.

Conclusion: s: 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.