• Yen-Chang Hsiao, Mohamed Abdelrahman, Chun-Shin Chang, Cheng-Jen Chang, Jui-Yung Yang, Chih-Hung Lin, Shu-Yin Chang, and Shiow-Shuh Chuang.
• Taipei, Taiwan; and Khartoum, Sudan From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University; and Khartoum University Clinic.
• Plast. Reconstr. Surg. 2014 Jun 1; 133 (6): 768e-775e.

BackgroundCarved autologous costal cartilage is widely used in different rhinoplasty procedures because of its availability and proven advantages. However, the usefulness of rib grafts is limited by warping postoperatively. The chimeric autologous costal cartilage graft is proposed. "Chimeric" means the combining of two different tissues (bone and cartilage in this case) to make a single dorsal onlay graft.MethodsFrom October of 2010 to August of 2013, 31 patients underwent rhinoplasty or nasal reconstruction with costal cartilage graft using the chimeric autologous costal graft method. There were 14 men and 17 women, with ages ranging from 20 to 66 years (average, 33 years). Of the 31 patients, there were 12 with congenital nasal deformities, six with previous nasal trauma, eight with aesthetic rhinoplasty (four with primary rhinoplasty and four with secondary rhinoplasty), and five with nasal deformities after tumor extirpation. Patients' profiles were documented and photographed. The outcomes were assessed by three plastic surgeons.ResultsFollow-up for all patients was 4 to 30 months (average, 14 months). No cartilage warping was noted during the follow-up period. Two patients suffered from minor infection 2 weeks postoperatively. The average operative time for carving cartilage was 10 minutes. The overall average time of making a chimeric autologous costal onlay graft added approximately 20 minutes to the original method.ConclusionFrom the clinical observation of all patients during the follow-up period, the chimeric autologous costal cartilage graft was shown to be effective for preventing cartilage warping.Clinical Question/Level Of EvidenceTherapeutic, IV.

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