Complications Associated With the Use of Autologous Costal Cartilage in Rhinoplasty: A Systematic Review.

BACKGROUND Autologous costal cartilage grafts are common in rhinoplasty. To date, no formal systematic review of complications associated with autologous costal cartilage grafting in rhinoplasty exists. OBJECTIVES The authors review current literature to examine the rates of donor and recipient site complications associated with autologous costal cartilage in rhinoplasty. METHODS Databases (EMBASE, PubMed, MEDLINE, and Cochrane Database of Systematic Reviews) and references of pertinent articles were searched between January 1980 to July 2014 to find studies evaluating rates of complications with autologous costal cartilage grafting in rhinoplasty. These studies were then screened with specific inclusion/exclusion criteria, and data were extracted from included studies and pooled for analysis. RESULTS A total of 21 eligible studies were included. Pooled donor site complication incidence was pneumothorax (0.1%), pleural tear (0.6%), infection (0.6%), seroma (0.6%), scar-related problems (2.9%), and severe donor site pain (0.2%). Pooled recipient site complications were as follows: warping (5.2%), infection (2.5%), displacement/extrusion (0.6%), graft fracture (0.2%), and graft resorption (0.9%). CONCLUSIONS Autologous costal rhinoplasty remains a safe procedure, but is associated with not insignificant rates of minor recipient site complications, such as warping. LEVEL OF EVIDENCE 4 Therapeutic.