Background Achieving long-term structural support and smooth contouring in rhinoplasty remains challenging due to the limited regenerative capacity of cartilage and the destructive nature of commonly used graft-processing techniques. This experimental study aimed to evaluate the viability, proliferation, and survival of a novel ultra-thin “fish-scale” cartilage graft technique compared with conventional cartilage processing methods. Methods Ten male New Zealand rabbits were used as an experimental model. Auricular cartilage grafts were harvested and divided into five groups: solid-block cartilage, ultra-thinned fish-scale cartilage prepared using a newly designed M-Slicer device, crushed cartilage, diced cartilage, and diced cartilage wrapped in fascia. All grafts were implanted into standardized dorsal subfascial pockets. After eight weeks, grafts were harvested for macroscopic evaluation, weight analysis, and histopathological examination using hematoxylin and eosin, Masson’s trichrome, and toluidine blue staining. Statistical analyses were performed using nonparametric tests. Results Significant differences were observed among groups regarding graft weight change, proliferation, and survival rates (p<0.01). The fish-scale cartilage group demonstrated the highest median weight gain and showed significantly greater chondrocyte proliferation and viability compared with crushed, diced, and fascia-wrapped diced cartilage grafts. Histopathological analysis revealed preserved cartilage architecture and increased peripheral chondrocyte proliferation in the fish-scale group. Fascia-wrapped diced cartilage exhibited the greatest volume loss and lowest survival rates. Conclusion Fish-scale cartilage grafts produced with minimal chondrocytic damage maximize surface area for diffusion and demonstrate superior survival and proliferation compared with traditional cartilage processing techniques. This method may offer a reliable alternative for camouflage and augmentation in rhinoplasty, potentially reducing resorption, irregularities, and revision rates. Level of Evidence II 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>.

Fish-Scale Grafts in Rhinoplasty: Ultra-thin, Ultra-viable

期刊论文
发表日期：

2026年8月5日

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Sabri Ozturk,
Memet Yazar,
Kamuran Zeynep Sevim,
Fevziye Kabukcuoglu,
Ezgi Ozdemir

摘要

Background

Achieving long-term structural support and smooth contouring in rhinoplasty remains challenging due to the limited regenerative capacity of cartilage and the destructive nature of commonly used graft-processing techniques. This experimental study aimed to evaluate the viability, proliferation, and survival of a novel ultra-thin “fish-scale” cartilage graft technique compared with conventional cartilage processing methods.

Methods

Ten male New Zealand rabbits were used as an experimental model. Auricular cartilage grafts were harvested and divided into five groups: solid-block cartilage, ultra-thinned fish-scale cartilage prepared using a newly designed M-Slicer device, crushed cartilage, diced cartilage, and diced cartilage wrapped in fascia. All grafts were implanted into standardized dorsal subfascial pockets. After eight weeks, grafts were harvested for macroscopic evaluation, weight analysis, and histopathological examination using hematoxylin and eosin, Masson’s trichrome, and toluidine blue staining. Statistical analyses were performed using nonparametric tests.

Results

Significant differences were observed among groups regarding graft weight change, proliferation, and survival rates (p<0.01). The fish-scale cartilage group demonstrated the highest median weight gain and showed significantly greater chondrocyte proliferation and viability compared with crushed, diced, and fascia-wrapped diced cartilage grafts. Histopathological analysis revealed preserved cartilage architecture and increased peripheral chondrocyte proliferation in the fish-scale group. Fascia-wrapped diced cartilage exhibited the greatest volume loss and lowest survival rates.

Conclusion

Fish-scale cartilage grafts produced with minimal chondrocytic damage maximize surface area for diffusion and demonstrate superior survival and proliferation compared with traditional cartilage processing techniques. This method may offer a reliable alternative for camouflage and augmentation in rhinoplasty, potentially reducing resorption, irregularities, and revision rates.

Level of Evidence II

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 www.springer.com/00266.