Somewhat surprisingly, the use of costal cartilage and rib cartilage in rhinoplasty and revision rhinoplasty has existed for more than a century. In an article published in Paris in 1904, French rhinoplasty surgeons describe harvesting rib cartilage and using it to repair the framework of a cartilage depleted nose during a reconstructive rhinoplasty. They obviously lacked the sophistication and precision of modern surgical techniques to harvest the cartilage in a minimally invasive manner, but nonetheless it is remarkable that they possessed the foresight to attempt such a surgery with the primitive instruments they had available to them despite facing incredibly high morbidity and the risk of disastrous complications.
Following the initial description, due to the complexity and inherent risks of harvesting rib cartilage, the use of costal cartilage for rhinoplasty surgery was largely limited to small subsets of reconstructive plastic surgery, and did not become widely utilized in the realm of cosmetic rhinoplasty surgery. Rhinoplasty surgeons such as Eugene Tardy, Jack Gunter, and later by Dean Toriumi, expanded the uses and indications of costal and rib cartilage in nose job surgery and began using it as the primary graft material in revision rhinoplasty cases where septal cartilage was not available, or insufficient. The acceptance of costal cartilage for use as a graft material in nose job surgery was gradual for the first 80-90 years since its inception, but in the last few decades has exploded to become the gold standard in revision rhinoplasty, and also in primary rhinoplasty cases where additional support or volume is needed. Korean plastic surgeons abroad, and plastic surgeons such as Donald Yoo and Charles Lee in Beverly Hills, California, have helped to spread awareness and widespread adoption of the use of autologous rib cartilage in primary rhinoplasty cases such as Asian rhinoplasty.
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Autologous costal cartilage and rib cartilage have proven to be reliable, permanent graft materials for use in nose job surgery that integrates seamlessly with the natural nasal framework. Autologous rib cartilage (cartilage from your own body) has the distinct advantage of being viable, living tissue and is intrinsically 100% immunocompatible with your nose, meaning there is no risk of rejection or resorption due to an immune response. Costal cartilage used as grafts obtains a blood supply from the nose, and becomes a permanent part of the nasal framework.
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