Structured Revision Rhinoplasty with Costal Cartilage: Case Reports

Introduction: Nowadays rhinoplasty is considered the most complicated procedure of face surgery. This surgery has functional and esthetic indications. Rhinoplasty is classified as incomplete (little removal) and destructive (excessive removal). Within the various materials that can be used in the nasal reconstruction, the septal cartilage is considered to be the best one. However, in cases of preoperated noses or without sufficient septal cartilage to use it, because of huge deformities, the costal cartilage is an excellent option.

Objectives: This study aims to review the three cases of patients with various degrees of deformities undergoing rhinoplasty with costal cartilage.

Resumed Report: A male patient (P. S.) presented with two previous septal surgeries. The first one was happened6 years ago, and the second surgery 2 years ago. After the second surgery, he evolved with collapse of the cartilaginous dorsum. Two female patients (W. O. and L. M. A.), underwent rhinoplasty 20 years ago and 6 years ago, respectively. Both had functional and esthetic unsuccessful results. L. M. A, despite the rhinoplasty 6 years ago, had worse functional and esthetic results due to the residual septal.

Conclusion: The costal cartilage is a material with good results both functional and esthetic in this surgery. It is possible to use it in surgeries of huge deformities, especially in the collapse of the cartilaginous dorsum, projection of the nasal tip, and nasal valve insufficiency. The surgeon is able to get all the material that he needs from a single rib, right between the fifth and the seventh rib. This technique provides a better projection of the dorsum and nasal tip. In addition, it allows an appropriated remodeling.