Use of Auricular Composite Graft in Rib Cartilage-Based Rhinoplasty for Contracted Nose Correction.

Background: This study investigated the effects of combining an auricular composite graft with rib cartilage-based rhinoplasty to correct contracted noses in Asian patients with a history of multiple previous operations.

Methods: A total of 43 patients were included in the retrospective analysis of secondary rhinoplasty procedures. The surgical approach involved short-nose correction, using rib cartilage for septal extension grafts and chondrocutaneous composite grafts harvested from the conchal part of the ear for internal nasal lining reconstruction. The authors' assessment encompassed clinical outcomes, the occurrence of complications; and the use of 3-dimensional photography for nasal measurements at the preoperative, 3-month, and 1-year postoperative stages.

Results: With regard to graft survival, 12 patients (27.9%) showed greater than 80% graft engraftment, 29 patients (67.4%) showed 50% to 80% graft engraftment, and 2 patients (4.6%) showed 20% to 50% graft engraftment. Two of these patients required wound irrigation for infection control and additional repair and were finally discharged without significant nasal deformity. At 3 months postoperatively, 3-dimensional anthropometry showed significant differences in nasal dorsum length (4.46 ± 1.79 mm), nasal height (1.25 ± 1.25 mm), nasal tip projection (4.06 ± 1.76 mm), and columellar-labial angle (22.75 ± 14.19 degrees). No significant relapse of nasal parameters was noted 1 year postoperatively.

Conclusions: Auricular composite graft combined with rib cartilage-based rhinoplasty enables the comprehensive restoration of nasal structures, addressing the inner, intermediate, and outer layers. This approach can serve as an effective and sustainable option for correcting contracted noses in Asian patients who have undergone multiple operations.

Clinical question/level of evidence: Therapeutic, IV.