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Page 10 of 16 Won et al. Plast Aesthet Res 2019;6:6 I http://dx.doi.org/10.20517/2347-9264.2018.82
Figure 12. Fixation of the dorsal graft with K-wire
Figure 13. Layers of costal cartilage cut with a dermatome blade can be stacked for dorsal augmentation
A B C
Figure 14. Dorsal augmentation with diced costal cartilage (A) wrapped in temporalis fascia (B); Final dorsal implant before insertion (C)
COMPLICATIONS OF RIB CARTILAGE AND ITS MANAGEMENT
Complications associated with using rib cartilage in rhinoplasty include warping, migration, infection,
operated look and donor site morbidity such as pain, pneumothorax, and chest scar. We hereby introduce
ways to deal with some of them.
Even with every preventive measure such as using the core of the rib cartilage, balanced carving, repeated
immersion and checking for warping, creation of a tight pocket for insertion, and suture fixation on the
dorsum, warping of the dorsal graft can occur [Figure 17]. When warping occurs postoperatively, we take
out the curved rib graft and reinsert it after carving it again into a straighter piece which is possible in
most instances. If that is not possible, we dice the rib graft and insert it after wrapping in temporalis fascia.
In our experience, autogenous rib cartilage is able to maintain its original volume years after surgery. If
