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Page 2 of 3 Jin. Plast Aesthet Res 2019;6:19 I http://dx.doi.org/10.20517/2347-9264.2019.28

and size, shape, and length of straight cartilaginous portion differs greatly from patient to patient. Tips on
evaluating and analyzing preoperatively and postoperative care considerations delivered by Jong-Sook Yi
will be of great help to the beginning rhinoplasty surgeons.

Recent advances in harvesting techniques focus on the minimal incision and minimal pain. Most surgeons
use 3.0 cm or more incision considering the depth of dissection and the size of harvesting cartilage.
Minimizing the size of the incision in harvesting was pioneered by Dean Toriumi and he reduced incision
size up to 1 cm. Although it is fascinating, it needs experience, skill, and patience, and it is not for all
rhinoplasty surgeons. As an alternative, an endoscope harvesting technique by Abdulkadir Goksel also
helps to minimize scar and pain.

Reducing the chest pain after harvesting was facilitated by several technical modifications: keeping the
underlying perichondrium intact, dissecting and retracting the covering muscles instead of cutting, and
harvesting cartilage partially leaving a thin layer of cartilage at the superior and inferior margins. Experts
will elaborate in great detail their techniques in terms of reducing postoperative pain.

The carving technique of costal cartilage was the main concern for rhinoplasty surgeons. Warping has
been the most criticized point, and the chances increase even more when using the rib for major dorsal
augmentation, which is quite common in Asian. A few key techniques to prevent warping including the
oblique splitting method by Fazil Apaydin has been introduced in this issue. I hope readers can modify
their techniques according to their situation by referring to these articles. Diced cartilage wrapped in
temporalis fascia has been popularized by Rollin Daniel. It has been introduced as a solution for warping
and its use is slowly increasing. Techniques to avoid drawbacks of dicing method are introduced by young,
talented surgeon Donald Yoo.

The final aspect of using costal cartilage is an application of the above-mentioned techniques in diverse
patients. Septal application includes splinting, replacement, extension, and spreader grafts. Dorsum and
tip applications include augmentation, reinforcement, camouflage, onlay, and strut grafts. Each application
has points to be addressed and these are also covered in many case series with illustrative patient photos by
Tae-Bin Won and Chuan-Hsiang Kao.

I am confident that this special issue will provide meaningful insight into the diverse aspects of using
costal cartilage in rhinoplasty. It is my sincere hope that readers will be able to enhance their skills and
integrate this cutting-edge knowledge into their practice to provide patients with the best experience
possible.

DECLARATIONS
Authors’ contributions
The author contributed solely to the article.

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
The author declared that there are no conflicts of interest.