This is a meta-analysis of complications associated with use of autologus costal cartilage in rhinoplasty involving 10 studies with 491 patients with a mean follow-up of 33 months. The results of the meta-analysis show a very low rate of complications either at the donor site (hypertrophic chest scarring, pneumothorax) or at the nose (warping, resorption and displacement) and a 14.7% rate in need of revision surgery. Although complication rates are really low, the high variation between studies is surprising, and especially with regards to warping (from 0% to 25.8%) and hypertrophic chest scarring (from 0% to 23.8%). The big differences in warping rate may be technique-related, since there are different ways to process the rib cartilage after the extraction and that has a direct impact on chances of postoperative warping. The hypertrophic scarring issue seems to be an ethnicity problem; the high rate of this complication in one of the studies is probably due to the high percentage of Asian and African patients in its sample. It is interesting to see how pneumothorax, which is probably the most alarming complication, is nearly absent in all of the studies and how the final average warping rate is only 3%, much lower than expected. Rib cartilage is a vital material for modern nose reconstruction; every rhinoplasty surgeon should learn how to get it and how to use it. This paper deals with the doubts that any beginner may have when using it for the first time.

Complications associated with autologous rib cartilage use in rhinoplasty: a meta-analysis.
Wee JH, Park MH, Oh S, Jin HR.
November 2014; Epub ahead of print.
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Eduardo Morera Serna

Hospital Universitario Son Espases, Palma de Mallorca, Spain.

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