Nasal Alar and Tip Reconstruction Following Mohs Surgery Using Fresh Frozen Human Costal Cartilage Allograft: A Novel Approach

Abstract

Background:. Skin cancer patients who undergo Mohs surgery may require subsequent reconstructive rhinoplasty for large nasal defects. Autologous cartilage is the primary source of supporting cartilage grafts, but carries the risk of potential donor-site complications. In this study, we demonstrate the safety and efficacy of nonterminally irradiated fresh frozen human costal cartilage allografts (CCAs) in reconstructive rhinoplasty after skin cancer removal. Methods:. A retrospective chart review of 25 patients who underwent reconstructive rhinoplasties using human CCA after basal cell carcinoma resection was conducted. Human CCA undergoes a process of sterilization without terminal irradiation and is stored frozen (−40°C to −80°C). Anthropometric measurements were taken on pre- and postoperative photographs to evaluate nasal tip projection. Adverse events were evaluated. Results:. There were 25 participants, with an average age of 71 years at the time of surgery (range: 42–90). The average follow-up duration was 12 months (range: 3–66 mo). Types of grafts used included alar batten graft (n = 17, 68%), nasal tip graft (n = 7, 28%), and alar batten graft with nasal tip graft (n = 1, 4%). Measurements on the 2-dimensional photographs of the patients showed no significant resorption or deviation at the 6- or 12-month follow-up. No significant complications related to the use of the cartilage were noted. Conclusions:. Our data highlight the low complication rate and aesthetically positive outcomes from using nonterminally irradiated human CCA for reconstructive rhinoplasties in post-Mohs surgery for older patients. This approach offers a reliable source of high-quality cartilage for reconstruction.