What is the best graft for nose surgery in the long-term?
Reviewed by Eduardo Morera Serna

The authors of this paper performed an experimental study on long-term histological changes in different grafts implanted subcutaneously in 25 New Zealand white rabbits. Ear cartilage, rib cartilage, autologous fascia, fascia allograft, diced rib and ear cartilage wrapped in autologous and allogenic fascia were inserted under the skin of the animals, who were sacrificed at three, six and nine months after surgery. Histologic work-up after removal of the grafts showed a greater calcification, ossification and fibrotic ingrowth of rib cartilage than ear cartilage, especially when wrapped in fascia. In the long-term no difference could be found between autologous fascia and fascia allograft (Tutogen fascia) in terms of inflammation, resorption or volume-loss. Chondrocyte viability reached an average of 50% in every cartilage construct, with a trend towards higher survival in the ear cartilage rather than the rib cartilage. This study provides valuable information on the quality and durability of the most popular grafts used in nose surgery. Many options are available for structural and cosmetic grafting in rhinoplasty and all of them have their pros and cons. Robustness and long-term survival are probably the two principal features requested and there has been great discussion on this topic for the last decades. The research conducted by Jurk et al. sheds new light on this old problem, which makes it a must-read article for every nose surgeon.

Long-term comparison of rib and ear cartilage grafts in autologous and allogenic fascia lata: an experimental study in a white rabbit model.
Jurk V, Kampmann H, Iblher N, et al.
PLASTIC AND RECONSTRUCTIVE SURGERY
2016;137(5):1465-74.