{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:03:55Z","timestamp":1779883435869,"version":"3.53.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":117,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fresh frozen costal cartilage (FFCC) has emerged as a promising alternative to autologous costal cartilage (ACC) in structural rhinoplasty, offering advantages such as elimination of donor site morbidity and reduced operative time. However, concerns remain regarding its complication profile compared with ACC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This meta-analysis compares postoperative complication rates between FFCC and ACC in rhinoplasty, focusing on infection, warping, resorption, and revision surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was performed according to PRISMA guidelines. MEDLINE, Embase, Web of Science, and Scopus were searched for studies published between January 1990 and March 2025. Eligible studies reported outcomes of rhinoplasty using FFCC or ACC in cohorts of \u22655 patients. Data were extracted on complication rates, patient demographics, follow-up duration, and study characteristics. Risk of bias was assessed using the ROBINS-I tool. Pooled complication rates and 95% CIs were calculated. Differences between graft types were assessed using unpaired 2-proportion z-tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-seven studies met inclusion criteria, encompassing 2137 patients in the ACC group and 766 in the FFCC group. The weighted mean follow-up was 18.4\u2005months for ACC and 23.0\u2005months for FFCC. Fresh frozen costal cartilage was associated with significantly lower rates of warping (1.2% vs 3.9%; P = .00038) and revision surgery (1.3% vs 3.4%; P = .0029). Infection (1.7% vs 2.3%; P = .34) and resorption rates (1.2% vs 1.9%; P = .25) were not significantly different between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fresh frozen costal cartilage demonstrates significantly lower rates of warping and revision surgery compared with ACC, with no increase in infection or resorption. Despite limitations related to study design and follow-up duration, these findings support FFCC as a safe and effective alternative to autologous grafts in rhinoplasty. Further prospective, controlled studies are needed to confirm these results and evaluate long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 3 (Risk)<\/jats:title>\n                    <jats:p>For image description, please refer to the figure legend and surrounding text.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/asjof\/ojag072","type":"journal-article","created":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T11:33:01Z","timestamp":1777203181000},"source":"Crossref","is-referenced-by-count":0,"title":["Fresh Frozen vs Autologous Costal Cartilage in Rhinoplasty: A Meta-Analysis of Complication Rates"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9963-2213","authenticated-orcid":false,"given":"Forrest","family":"Bohler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ethan","family":"Dimock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Liao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmina","family":"Samaha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0855-3764","authenticated-orcid":false,"given":"Shaishav","family":"Datta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Mattos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G","family":"Reish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"2026052707024408100_ojag072-B1","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1001\/jamafacial.2015.2251","article-title":"Reconstructive rhinoplasty using multiplanar carved costal cartilage","volume":"18","author":"Nuara","year":"2016","journal-title":"JAMA Facial Plast Surg"},{"key":"2026052707024408100_ojag072-B2","article-title":"Dorsal augmentation: a review of current graft options","volume":"23","author":"Wright","year":"2023","journal-title":"Eplasty"},{"key":"2026052707024408100_ojag072-B3","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.16724","article-title":"Dorsal augmentation rhinoplasty by cartilage allograft","volume":"24","author":"Harutyunyan","year":"2025","journal-title":"J Cosmet Dermatol"},{"key":"2026052707024408100_ojag072-B4","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1001\/jamaoto.2019.4787","article-title":"Comparison of autologous vs homologous costal cartilage grafts in dorsal augmentation rhinoplasty: a systematic review and meta-analysis","volume":"146","author":"Vila","year":"2020","journal-title":"JAMA Otolaryngol Neck Surg"},{"key":"2026052707024408100_ojag072-B5","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1055\/s-0037-1607065","article-title":"Cartilage graft donor site morbidity following rhinoplasty and nasal reconstruction","volume":"11","author":"Ho","year":"2018","journal-title":"Craniomaxillofacial Trauma Reconstr"},{"key":"2026052707024408100_ojag072-B6","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1001\/jamafacial.2017.1363","article-title":"Association of autologous costal cartilage harvesting technique with donor-site pain in patients undergoing rhinoplasty","volume":"20","author":"\u00d6z\u00fccer","year":"2018","journal-title":"JAMA Facial Plast Surg"},{"key":"2026052707024408100_ojag072-B7","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1093\/asj\/sju117","article-title":"Complications associated with the use of autologous costal cartilage in rhinoplasty: a systematic review","volume":"35","author":"Varadharajan","year":"2015","journal-title":"Aesthet Surg J"},{"key":"2026052707024408100_ojag072-B8","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1007\/s00266-022-03075-3","article-title":"Complications associated with autologous costal cartilage used in rhinoplasty: an updated meta-analysis","volume":"47","author":"Chen","year":"2023","journal-title":"Aesthetic Plast Surg"},{"key":"2026052707024408100_ojag072-B9","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1177\/22925503211011973","article-title":"Is irradiated homologous costal cartilage reliable? 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