Complications Associated with Autologous Costal Cartilage Used in Rhinoplasty: An Updated Meta-Analysis

Aesthetic Plast Surg. 2023 Feb;47(1):304-312. doi: 10.1007/s00266-022-03075-3. Epub 2022 Sep 7.

Abstract

Objective: To estimate the complications using autologous costal cartilage as grafts in rhinoplasty objectively and systematically with newly published literature.

Methods: The literature was searched systematically; included studies were published between July of 1990 and April of 2020. Meta-analysis was performed using a random-effects model.

Results: Twenty studies involving 1648 patients were included for meta-analysis. The pooled rates of complications were 3.05% of warping (95% CI 1.36-5.19%), 1.2% of resorption (95% CI 0.26-2.56%), 1.45% of infection (95% CI 0.34-3.06%), and 1.53% of contour irregularity (95% CI 0.53-2.88%). The revision rate was 2.25% (95% CI 0.96-3.9%). Regarding of donor-site morbidities, the rate of hypertrophic chest scar was 2.08% (95% CI 0.31-4.83%), and the rate of pneumothorax was 0% (95% CI 0-0.46%). The pooled rates of complications were 9.06% (95% CI 6.13-12.43%) at the recipient site when complications at the recipient site did not include revision surgery, 1.47% (95% CI 0.17-3.56%) at the donor site, and 15.13% (95%CI 11.03-19.69%) overall. The recipient-site adverse event rate was 12.44% (95% CI 8.98-16.33%).

Conclusions: Warping was found the most common complication after rhinoplasty with autologous costal cartilage. Revision after rhinoplasty using autologous costal cartilage was increased in these years. Donor-site complications increased the complication rate after rhinoplasty using autologous rib cartilage by 22%.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Cicatrix, Hypertrophic*
  • Costal Cartilage* / transplantation
  • Humans
  • Reoperation
  • Retrospective Studies
  • Rhinoplasty* / adverse effects
  • Thorax
  • Transplantation, Autologous / adverse effects
  • Treatment Outcome