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Aim: To assess the safety profile and practice trend of autologous costal cartilage harvest by facial plastic surgeons in the United States (US). Methods: A 10-question online survey was distributed by the American Academy of Facial Plastic and Reconstructive Surgery to its members. Results: Of the 2,639 members, 2,379 received the survey with 137 (5.76%) members responded. The majority (33.6%) of the respondents were expert facial plastic surgeons. One hundred and nine (79.6%) of the respondents performed rib harvest with 49.6% of them performing the procedure at a hospital facility. Among them, 21.5% exclusively performed their surgery at an ambulatory surgical center not physically attached to a hospital while 6.67% of them at the in-office accredited operating room. When comparing techniques, 64.7% performed only full-thickness rib grafts vs. 12.0% harvesting partial-thickness rib grafts. Most used an incision length between 2.1 and 4 cm (64.4%) while 2 surgeons used < 1 cm incision. The occurrence of pneumothorax after autologous rib harvest remained low (< 1%) in most (73.1%). Regarding safety practices of the surgeons, only 24.6% would order a chest X-ray post-operatively while 54.5% would not. In addition, 58.7% of respondents never kept their patients overnight for observation after autologous rib grafting while 15.0% always would. For pain management, most respondents (50.4%) did not utilize any additional analgesia protocol besides oral pain medications. Conclusion: Two thirds of the US facial plastic surgeons performed autologous costal cartilage harvest in a hospital setting. Routine chest imaging or overnight observation post-operatively was not warranted as the percentage of pneumothorax remained low and pain control was adequate.

The current trend of autologous costal cartilage harvest by facial plastic surgeons for rhinoplasty in the United States