Rhinoplasty - Costal cartilage harvest

Considerations

• • Anatomy 

  • Costal cartilage

  • Intercostal nerves

  • Intercostal space contains the neurovascular bundle located at the inferior aspect of the respective rib 

  • 2012: Harvesting Rib Cartilage Grafts for Secondary Rhinoplasty - excellent technical description with photos 

Preparation

Procedure

Sample operative report

Post-op

• • Medications 

    • Analgesic

    • No antibiotics indicated for this procedure alone

• Wound care 

  • Keep dry until 2 days after the OnQ catheter is removed

  • Note: The local anesthetic often leaks from the skin at the catheter insertion site 

  • Do not submerge the wound under water for 2 weeks 

• Activity 

  • Light activity for the first 2 weeks 

  • No heavy lifting for 4 weeks 

• Follow up

  • RTC 1 week for removal of steri-strips and OnQ catheter with its Tegaderm dressing  

  • CPT codes

    • 21230 - Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)

    • 11981 - Insertion, non-biodegradable drug delivery implant

Pearls & Pitfalls

High-Yield

Links