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Published on: June 20, 2018
Adverse Outcomes and Complications of Autologous Versus Homologous Costal Cartilage Grafts in Septorhinoplasty: A
Witsanu Jullamusi1, Kritsada Kowitwibool2, Amontep Mungmee3
1Facial Plastic and Reconstructive Division, Department of Otorhinolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Aesthetic Surgery Journal
|June 30, 2026
Summary
This review found that different types of costal cartilage grafts used in rhinoplasty have similar complication rates. Graft selection for rhinoplasty should consider factors like availability and surgeon experience, not just complication differences.
Area of Science:
- Plastic Surgery
- Regenerative Medicine
- Biomaterials Science
Background:
- Costal cartilage is a common graft material in rhinoplasty when septal cartilage is insufficient.
- Limited comparative data exists on complication rates for various costal cartilage processing methods.
Purpose of the Study:
- To systematically review and meta-analyze complication rates of different autologous costal cartilage (ACC), irradiated homologous costal cartilage (IHCC), Tutoplast-processed cartilage, and fresh-frozen costal cartilage grafts.
- To compare the safety profiles of these graft types in rhinoplasty procedures.
Main Methods:
- Systematic review and meta-analysis following PRISMA guidelines.
- Inclusion of 50 studies with 4,482 patients.
- Random-effects meta-analysis to pool complication rates for warping, resorption, infection, extrusion, revision surgery, and patient dissatisfaction.
Main Results:
- Overall low pooled complication rates were observed across all graft types.
- No significant differences in complication rates were found among ACC, IHCC, Tutoplast, and fresh-frozen cartilage.
- Specific graft configurations (laminated vs. en bloc) and types (fresh-frozen vs. ACC) influenced warping rates for dorsal onlay grafts.
Conclusions:
- Autologous costal cartilage, irradiated homologous costal cartilage, Tutoplast-processed cartilage, and fresh-frozen costal cartilage grafts demonstrate comparable safety profiles in rhinoplasty.
- Graft selection may be influenced by availability, cost, and surgeon experience due to similar complication rates.
- Further prospective, standardized studies with long-term follow-up are needed to confirm findings, given the risk of bias and heterogeneity in current research.
