What is auricular cartilage transplantation? How it reshapes the nasal tip and what changes occur over time

Auricular cartilage transplantation is a procedure that removes a portion of cartilage from the ear and transfers it to the nasal tip or nasal columella (the structure between the nostrils) to refine shape and provide support.[1]It is used to layer over the nasal tip to refine its shape or to support the nasal columella.[1]However, over time the height of the nasal tip may decrease or the structural support of the nose may weaken, according to reports.[2][3].

Where in the nose is ear cartilage used?

The main uses are the nasal tip and nasal columella. Common applications include layering over the nasal tip, placing it in a shield shape beneath the nasal tip, lowering an upturned nasal tip, and providing internal support for the nasal columella.[1].

In revision surgery, it is also used to stabilize the support in the middle of the nose or to straighten a deviated nasal septum (the wall inside the nose).[2]There is also a method where tissue including skin is removed to repair missing portions of the ala or nasal columella.[1].

Does the shape change over time?

Changes can occur. In a study following 27 patients who underwent nasal tip surgery over an average of 453 days (approximately 1 year and 3 months), auricular cartilage showed greater reduction in nasal tip height compared to costal cartilage (cartilage from the rib).[3].

Textbooks also note that auricular cartilage can weaken the nasal structure over time and may prove insufficient in terms of appearance and nasal function in the long term.[2]However, the study cited had a small sample size, and results may change with future research.

How does it differ from costal cartilage?

Costal cartilage is often chosen for complex nasal reconstruction due to its strength and ability to maintain shape over time.[4]It is used widely in revision surgery for the nasal tip, alar rim, and middle nasal support.[5].

A study combining data from 888 patients reported that complications from nasal surgery using costal cartilage occurred in 7–8% of cases, with satisfaction rates of 89–92%.[4]A large study comparing auricular cartilage in the same context was not found in this review.

Auricular cartilage is primarily used for refining the nasal tip and nasal columella.[1]When strong support is needed, costal cartilage is used; when refinement alone is the goal, auricular cartilage is used—the choice depends on the intended purpose.[4][1].

Is the ear shape or scarring a concern?

Cartilage removal via an incision behind the ear has been reported.[6]This is a method that cuts in a location not easily visible from the front.

On the other hand, some facilities use auricular cartilage less frequently due to concerns about cartilage quality and potential complications at the harvesting site.[6]Data showing the rate at which such problems occur were not found in the scope of this review.

Can auricular cartilage alone reduce the roundness of the nasal tip?

In people with thick skin, complete reduction may not be possible. There is a report of 22 patients in whom roundness of the nasal tip persisted after cartilage reshaping, and additional surgery to remove excess skin and tissue was performed.[7].

In other words, the final appearance of the nasal tip is influenced not only by cartilage shape but also by skin thickness. It is important to have a consultation to determine whether auricular cartilage transplantation can achieve the desired result.

What should be confirmed during consultation to determine if this is right for you?

Three things are important to confirm: how much you want to change the nasal tip, the thickness of the nasal tip skin, and whether your nose requires strong structural support.

These three factors determine whether auricular cartilage alone is sufficient or whether other materials would be better. During consultation, ask for an explanation of why that material was chosen and what changes to expect over time.