Innovation in Rhinoplasty

Innovation in Rhinoplasty:

Injectable Cartilaginous Microtissue Regenerated by Autologous Chondrocytes

A recent 5-year study, published in Plastic and Reconstructive Surgery this June, presents a revolutionary new technique in rhinoplasty: injectable cartilaginous microtissue (ICM). Developed by Dr. Dan Li and his team, this approach uses autologous chondrocytes to regenerate cartilage, offering a minimally invasive solution for nasal augmentation.


– 1.0 cm² of atrial cartilage was collected from 28 patients.

– Isolated chondrocytes were expanded and cultured in chondrogenic media with growth factors for 3 weeks.

– The cultured cartilage is granulated and injected subcutaneously for rhinoplasty.



– The ICM was successfully prepared in all patients, efficiently elevating the nasal dorsum.

– MRI confirmed the presence of regenerated tissue, and histological examinations showed mature cartilage formation.

– 83.3% of patients reported excellent or good satisfaction during the 5-year follow-up.

– Only two patients (8.3%) experienced remarkable graft absorption.


Innovation and Methodology


The ICM approach uses cultured, granulated autologous cartilage, which allows precise injections for nasal augmentation. The methodology of collecting a small sample of auricular cartilage and expanding chondrocytes in chondrogenic media is remarkable for its ability to generate functional and stable cartilage. This process minimizes the risks associated with graft rejection and infectious complications, critical aspects in rhinoplasty procedures.


Promising Results


The results of the study are impressive. With a satisfaction rate of 83.3% over five years and only 8.3% remarkable graft absorption, the ICM proves to be an effective and durable technique. Confirmation by MRI and histological examinations showing mature cartilage formation underline the feasibility of this approach in the long term. This finding is crucial since one of the most important limitations in traditional rhinoplasty is graft resorption and the need for surgical revisions.


Clinical and Future Implications


The ability to perform nasal augmentations with a minimally invasive approach could have a significant impact on clinical practice. This technique not only offers natural aesthetic results but also reduces recovery time and postoperative complications, which is a great benefit for both patients and surgeons.


However, although the results are promising, further studies with a larger number of patients and longer follow-up are needed to confirm the long-term stability and safety of MCI. In addition, it would be interesting to explore the applicability of this technique in other reconstructive and aesthetic procedures, which could significantly broaden its impact in plastic surgery.


Some limitations


Although the study on injectable cartilage microtissue (ICM) for nasal augmentation shows promising results, it is important to also consider the limitations and possible negative aspects of this technique:


  1. Procedural Complexity

The ICM technique requires a complex and specialized process of chondrocyte culture and microtissue formation. This involves:

– Cartilage Harvesting: The need to harvest auricular cartilage can be uncomfortable and present risks of complications at the harvest site.

– Culture and Granulation: Chondrocyte culture and subsequent cartilage granulation require highly specialized facilities and personnel, which may not be available at all clinical centers.


  1. High Costs

The cell culture process and preparation of cartilage microtissue are expensive. Associated costs include:

– Specialized Equipment: Requires advanced equipment for cell culture and microtissue creation.

– Skilled Labor: The need for highly skilled personnel can increase operating costs.


  1. Preparation Time

The MCI technique does not offer an immediate solution. Cartilage microtissue preparation takes several weeks, which may not be suitable for all patients. This waiting time can be inconvenient for those seeking faster results.


  1. Availability Limitations

Currently, the ICM technique may not be available in all medical centers. This limits its accessibility and widespread use in daily clinical practice. Limited availability may delay the wide-scale adoption and benefits of this technology.


Insufficient volume

It is well known that the effectiveness of nasal torso reconstruction for deep defects requires abundant solid volume.

The images presented in the article show patients with moderate volumes and residual results, valid for the correction of small touch-ups but insufficient for the replacement of large volumes.



Plastic and Reconstructive Surgery