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Apaydin. Plast Aesthet Res 2019;6:9 Plastic and
DOI: 10.20517/2347-9264.2018.73 Aesthetic Research

Technical Note Open Access

Oblique split technique: a game changer in costal
cartilage sculpting

Fazil Apaydin

Department of Otorhinolaryngology, Bornova, Izmir 35100, Turkey.

Correspondence to: Prof. Dr. Fazil Apaydin, Department of Otorhinolaryngology, Bornova, Izmir 35100, Turkey.
E-mail: fazil.apaydin@ege.edu.tr
How to cite this article: Apaydin F. Oblique split technique: a game changer in costal cartilage sculpting. Plast Aesthet Res 2019;6:9. http://
dx.doi.org/10.20517/2347-9264.2018.73

Received: 10 Oct 2018 First Decision: 18 Mar 2019 Revised: 27 Mar 2019 Accepted: 29 Mar 2019 Published: 26 Apr 2019

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

Abstract

Oblique split method is a technique used to carve the costal cartilage. Its main advantages are the high number of grafts
that can be obtained, the ability to obtain grafts of various thicknesses and lengths, no risk of warping, less chance of
desorption, preservation of the straight forms of grafts although they can be carved in different shapes.

Keywords: Oblique split method, saddle nose, structural rhinoplasty, revision rhinoplasty, septal reconstruction

INTRODUCTION
Costal cartilage is one of the main sources for grafts in the reconstruction of saddle nose deformities and
revision rhinoplasty cases. However, its handling and carving methods have always created a challenge for
the surgeon. In 1958, Gibson and Davis published a technique called as “principle of the balanced cross-
section” which could be used to overcome warping, the major disadvantage of the use of carved/sculpted
[1]
costal cartilage . They stated that if the distorting forces were balanced along a cartilage graft, the grafts
would not be distorted (warp). In total 46 balanced cross-section grafts were followed for over a three-year
[2]
period. The oblique split method after Taştan et al. describes the angle to the long axis of the rib cartilage
upon which the costal cartilage is cut/sectioned. In this original description was there was no clinical
observation of graft warping in the follow-up period. It was also stated that although the grafts obtained
could be modified into different shapes, they preserved their straight shape.

© 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
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