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Rajbhandari et al. Plast Aesthet Res 2019;6:8 Plastic and
DOI: 10.20517/2347-9264.2018.86 Aesthetic Research

Technical Note Open Access

Costal cartilage graft in Asian rhinoplasty: surgical
techniques

Sarina Rajbhandari , Chuan-Hsiang Kao 2
1
1 Department of Otolaryngology - Head and Neck Surgery, Himal Hospital, Kathmandu 44600, Nepal.
2 Department of Otolaryngology - Head and Neck Surgery, Tri-Service General Hospital, Taipei 11490, Taiwan.
Correspondence to: Dr. Chuan-Hsiang Kao, Department of Otolaryngology-Head and Neck Surgery, Tri-Service General
Hospital, No 325, Sec. 2nd, Cheng-Kung Road, Neihu District, Taipei 11490, Taiwan. E-mail: chuanhsiang@yahoo.com.tw

How to cite this article: Rajbhandari S, Kao CH. Costal cartilage graft in Asian rhinoplasty: surgical techniques. Plast Aesthet
Res 2019;6:8. http://dx.doi.org/10.20517/2347-9264.2018.86

Received: 31 Dec 2018 First Decision: 7 Mar 2018 Revised: 19 Mar 2019 Accepted: 2 Apr 2019 Published: 18 Apr 2019
Science Editor: Hong Ryul Jin Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
Asian rhinoplasty is a very common cosmetic procedure. Many Asians desire a higher nasal bridge, for which they
undergo several procedures, including filler injections, implantations and insertion of threads. Surgeons encounter
many patients who have had several procedures done on them previously. In this paper, we introduce the use of
autologous grafts for Asian rhinoplasty (primary and secondary), and discuss the rib carving techniques and difficulties
encountered during harvesting, carving and placements of grafts and how to overcome these problems and prevent
complications.

Keywords: Rhinoplasty, costal cartilage, Asians, warping

INTRODUCTION
Surgeons who perform Asian rhinoplasty often have to treat patients who have had rhinoplasty (or several
rhinoplasties) previously. Revision rhinoplasty is one of the most difficult and challenging surgeries in facial
plastic surgery.

For treating complications in rhinoplasty, a considerable quantity of cartilage is required to correct both
nasal contour deformities and functional problems caused by previous surgeries. Revision Asian rhinoplasty
tends to be a more complicated procedure than primary rhinoplasty, especially due to framework deficiency,
that needs further reconstruction. For consistent long-term results, surgeons should use grafts with low

© 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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