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Olcott et al. Plast Aesthet Res 2019;6:3                                     Plastic and
               DOI: 10.20517/2347-9264.2018.79                                   Aesthetic Research




               Original Article                                                              Open Access


               The current trend of autologous costal cartilage
               harvest by facial plastic surgeons for rhinoplasty in

               the United States

               Clara M. Olcott , Steven J. Pearlman 2
                            1

               1 Inland Ear Nose & Throat-Facial Plastics, Upland, CA 91784, USA.
               2 Pearlman Aesthetic Surgery, New York, NY 10022, USA.

               Correspondence to: Dr. Clara M. Olcott, Inland Ear Nose & Throat-Facial Plastics, 1030 E. Foothill Blvd., Suite 101, Upland, CA 91784,
               USA. E-mail: clara.olcott@gmail.com

               How to cite this article: Olcott CM, Pearlman SJ. The current trend of autologous costal cartilage harvest by facial plastic surgeons for
               rhinoplasty in the United States. Plast Aesthet Res 2019;6:3. http://dx.doi.org/10.20517/2347-9264.2018.79
               Received: 27 Nov 2018    First Decision: 28 Nov 2018    Revised: 16 Jan 2018    Accepted: 23 Jan 2019     Published: 19 Feb 2019


               Science Editor: Hong Ryul Jin    Copy Editor: Cai-Hong Wang    Production Editor: Huan-Liang Wu



               Abstract

               Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by facial plastic surgeons in
               the United States (US).

               Methods: A 10-question online survey was distributed by the American Academy of Facial Plastic and Reconstructive
               Surgery to its members.

               Results: Of the 2,639 members, 2,379 received the survey with 137 (5.76%) members responded. The majority (33.6%)
               of the respondents were expert facial plastic surgeons. One hundred and nine (79.6%) of the respondents performed rib
               harvest with 49.6% of them performing the procedure at a hospital facility. Among them, 21.5% exclusively performed
               their surgery at an ambulatory surgical center not physically attached to a hospital while 6.67% of them at the in-office
               accredited  operating  room.  When  comparing  techniques,  64.7%  performed  only  full-thickness  rib  grafts vs.  12.0%
               harvesting partial-thickness rib grafts. Most used an incision length between 2.1 and 4 cm (64.4%) while 2 surgeons
               used < 1 cm incision. The occurrence of pneumothorax after autologous rib harvest remained low (< 1%) in most (73.1%).
               Regarding safety practices of the surgeons, only 24.6% would order a chest X-ray post-operatively while 54.5% would
               not. In addition, 58.7% of respondents never kept their patients overnight for observation after autologous rib grafting
               while 15.0% always would. For pain management, most respondents (50.4%) did not utilize any additional analgesia
               protocol besides oral pain medications.

                           © The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
                           International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
                sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
                as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
                and indicate if changes were made.


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