Background <p>Autologous costal cartilage was preferred in Chinese rhinoplasty. However the severe postoperative pain at the donor site was a common morbidity, which hindered patient’s daily activities.</p> Objective <p>To evaluate postoperative pain at the donor site after harvesting the 6th costal cartilage by preserving interchondral joints (ICJ) with its adjacent 5th and 7th costal cartilages.</p> Methods <p>Forty patients underwent the 6th costal cartilage harvest for rhinoplasty, with the preservation of ICJ with its adjacent 5th and 7th costal cartilages in 20 patients (PICJ group), and non-preservation of ICJ in other 20 patients (NPICJ group). Each patient underwent a preoperative computed tomography to determine calcification of 6th costal cartilage and its interchondral joints with 5th and 7th costal cartilages. The postoperative pain at donor site was recorded and evaluated according to the Visual Analog Scale (VAS).</p> Results <p>Between January 2023 and March 2025, 40 female patients underwent rhinoplasty with autologous costal cartilage. The mean length of the harvested costal cartilages was 33.2 ± 3.79 mm in PICJ group and 32.45 ± 3.5 mm in NPICJ group (P&gt;0.05). The mean postoperative VAS scores in PICJ group were 4.15 (vs. 5.10), 1.95 (vs. 2.85), 0.80 (vs.1.40), 0.05 (vs. 0.2), 0.0 (vs. 0.1) on the 1st, 3rd, 7th, 14th and 30th day post operation, respectively, compared with that in NPICJ group. No hematoma, infection and pneumothorax at donor site was found in all patients.</p> Conclusion <p>This costal cartilage harvest technique with the preservation of interchondral joints can decrease postoperative pain at the donor site, and obtain abundant amount costal cartilage.</p> Level of Evidence II <p>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a></p>