Auricular cartilage: harvest technique and versatility in rhinoplasty

Effects of Carving Plane, Level of Harvest, and Oppositional Suturing Techniques on Costal Cartilage Warping

“…[1][2][3][4] Synthetic/alloplastic implants have been beleaguered by their predisposition to foreign body reactions and extrusion, and heterografts were virtually abandoned after their unavoidable resorption rate and limitations with longevity. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Historically, one of the major obstacles of costal cartilage use that had plagued rhinoplasty and plastic surgeons was its inherent warping characteristics. Over the years, various costal cartilage harvesting and prefabrication techniques (e.g., combining an osseous portion or using irradiated cartilage, perichondrial preservation, carving principles, and hardware placement) have all been implemented by pioneers in rhinoplasty such as Gillies, Gibson, Davis, Fry, Millard, Gunter, and Daniel to counteract the unpredictability and to decrease the intrinsic warping tendencies of rib cartilage.…”

A New Technique for Conchal Cartilage Harvest

“…The anterior approach allows easier dissection, with better visible landmarks for preserving the shape of the ear [2], and a larger amount of cymba cartilage can be harvested. Furthermore, the anterior approach allows the preservation of the neurovascular system distributed along the posterior surface of the ear.…”

“…Septal cartilage is generally considered the preferred graft material, being located at an optimal site. Its advantages include anatomic location within the same operative field and abundant availability of the cartilage [2]. However, the availability of the septal cartilage is limited in patients undergoing revision surgery, patients with a history of nasal trauma, or those with septal perforation.…”

“…Typically, when auricular cartilage is utilized, conchal cartilage is preferred [4]. Several factors must be considered when harvesting conchal cartilage: harvesting an adequate amount, obtaining cartilage without inflicting damage during surgery, and ensuring that there are no postoperative changes to the shape of the ear [2]. …”

Autologous Rib Grafts in the Management of the Crooked Nose

“…Though auricular cartilage harvest has minimal donor-site complications, its intrinsic elasticity and curvature make it less useful in correction of the crooked nose. 5 Irradiated homologous cartilage allografts have been described as a grafting source in rhinoplasty but have fallen out of favor due to propensity for unpredictable resorption over time. 6,7 Alloplastic implants such as silicone or porous polyethylene have also been described for use in rhinoplasty but carry with them risks of extrusion, infection, foreign-body reaction, as well as scarring of the soft tissue envelope of the nose.…”