Central segment harvest of costal cartilage in rhinoplasty

Objectives/Hypothesis: Our objective was to review our experience with a conservative central boat harvest of costal cartilage in patients undergoing rhinoplasty. It involves taking only the central portion of the rib for reconstruction. When cartilage harvest is performed in the above manner, donor site morbidity is minimized without limiting aesthetic results. The key seems to be preservation of intact costal cartilage on three sides, limiting harvest to the central portion only. This central portion is straight and much less prone to warping than the cartilage toward the periphery. Study Design: A retrospective review of a single surgeon's experience. Methods: All rhinoplasty operations performed by the senior author (Y.D.) from January 2000 to August 2009 that required the harvest of rib cartilage were reviewed. Results: A total of 322 cases were identified in which rib cartilage was harvested via the described technique. In all cases sufficient cartilage volume was obtained for the intended purpose. Average operation time was 10 minutes. No drains were used, and only one patient developed seroma formation. Postoperative pain and scar were minimal. No major complications were noted, and on postoperative analysis there was no evidence of cartilage warping or displacement. Conclusions: When harvesting costal cartilage for rhinoplasty, the above technique allows for sufficient graft tissue while decreasing donor site morbidity and minimizing warping.