Analysis of the Cause of Cartilage Warping in the Rhinoplasty of Costal Cartilage and Application of Embed-In Graft in Revisional Surgery

Background: It is undeniable that costal cartilage is an excellent source of grafts, however it has some potential disadvantages, including a tendency to warp. There are very few studies that have examined how to resolve preexisting cartilage warping during secondary revisional surgery.Objectives: The aim of this study was to explore causes of cartilage warping other than the cartilage itself and ways to correct cartilage warping during revisional surgery.Methods: In the present study, cases of cartilage warping in the past 5 years were retrospectively reviewed, and external factors of cartilage warping were evaluated to help design new cartilage grafts that could be employed to repair cartilage deformities.Results: A total of 29 females and 3 males between the ages of 18 and 60 years participated in the study (average age, 32.5 years). In all cases, embed-in grafts were utilized to correct warping. All patients were satisfied with the results. As a result of our research, we found that another external cause of cartilage warping was the hump that was not removed completely during the initial surgery.Conclusions: Incomplete removal of the hump is a major contributing external factor to cartilage warping, particularly in the sagittal plane. This embed-in graft is not intended as a routine graft in normal circumstances, but rather as an immediate means of solving an unexpected situation. The graft is primarily for management of severely warped cartilage.