Endoscopic-assisted rib cartilage harvesting for revision rhinoplasty

Abstract

We describe the endoscopic-assisted rib harvesting technique for secondary rhinoplasty as minimum-invasive and safe harvesting method. Endoscopic-assisted rib harvesting was performed on 52 patients for revision rhinoplasty in last two years (2017-2019). Adequate amount of cartilage was obtained through 1-2 cm incision. The 30 degrees angled endoscope was used for vision control. Fifty-two patients underwent rhinoplasty with costal cartilage harvested using endoscopic-assisted method. The length of the harvested cartilage blocks from the rib was 5 ± 1.5 cm in average. There were no associated intraoperative complications. Postoperative complications were less than by the conventional rib harvesting technique: in all cases, no signs of pneumothorax or excessive bleeding were detected after surgery. The wound healed without significant scarring in 50 (96%) cases. Two patients (4%) showed hypertrophic scar formation. Postoperative pain was evaluated by using Visual Pain Analog Scale retrospectively. Forty-eight patients (92%) scored 1.43 ± 0.7 experienced no significant postoperative pain. Only 4 patients (8%) scored 4.1 ± 0.8 and complained of slight postoperative pain. This technique provides an effective and less-invasive alternative for conventional costal cartilage harvesting with reduced complications risk and extended visualization. Patients benefit from an inconspicuous scar and reduced postoperative pain. Technique can be applied for revision and primary rhinoplasty and allows achieving reproducible aesthetically and functionally successful results with minimized risks.

Complications of Costal Cartilage Asian Rhinoplasty and Their Management

“…Novel techniques include an endoscope-assisted harvesting technique 29 and a transumbilical endoscopic costal cartilage harvesting method. 30 However, the operative time of harvesting is prolonged to 2 to 2.5 hours.…”

Harvesting the Entire Seventh Costal Cartilage for Secondary Rhinoplasty

“…Previous published articles have introduced harvest methods that yield less cartilage than this procedure. 4 , 6 , 8 More options are needed to harvest large amounts of cartilage, such as that obtained using our method. Concerns about deformities after harvest are also noted.…”