Irradiated Homologous Rib Grafts in Nasal Reconstruction

To assess the long-term efficacy of irradiated homologous rib grafts (IHRGs) for both augmentation and support function in rhinoplasty in general and for specific recipient sites within the nose.A retrospective study was conducted at an academic medical center to evaluate the loss of volume and support function of IHRGs in 9 specific recipient sites in the nose.We studied 66 patients, with a total of 177 IHRGs, dating back 9 years, with an average follow-up of 51 months. The rate of resorption increased with duration of follow-up. Complete resorption was found in 1 IHRG, and moderate resorption was observed in 55 IHRGs (31%). Resorption was characterized by a loss of support function rather than a loss of volume. Moderate resorption had a negative clinical outcome for shield grafts only.Irradiated homologous rib grafts were safe to use in rhinoplasty. In cases requiring a shield graft, IHRGs should be avoided.