Background <p>Secondary rhinoplasty often requires autologous costal cartilage harvest, and donor-site pain may influence recovery. This study evaluated whether rib stabilization is associated with improved postoperative pain control and reduced analgesic burden.</p> Methods <p>In this retrospective comparative study, records of 21 patients who underwent secondary rhinoplasty with costal cartilage harvest between January and December 2025 were reviewed. Patients were grouped by donor-site management (stabilization vs. no stabilization). Pain was assessed using visual analog scale scores on postoperative day 0, day 1, day 10, and day 30. Analgesic use, opioid requirement, and hospital stay were compared. Longitudinal pain trajectories were analyzed using RM-ANOVA. Baseline comparability and categorical analgesic outcomes were assessed between groups with appropriate parametric or nonparametric tests.</p> Results <p>Pain scores decreased significantly over time in both groups. Repeated-measures analysis showed a significant time effect and a significant time-by-group interaction, indicating different pain trajectories according to stabilization status. The stabilization group showed numerically lower VAS scores, shorter hospital stay, and fewer patients requiring opioids. Between-group differences in nonsteroidal analgesic use were borderline, whereas opioid requirement differed significantly.</p> Conclusion <p>In this small, retrospective, non-randomized cohort, donor-site rib stabilization was associated with lower early postoperative pain scores and reduced opioid use after costal cartilage harvest in revision rhinoplasty. However, the observed associations cannot be interpreted as causal, and the findings should be regarded as preliminary and hypothesis-generating. Adequately powered prospective studies with standardized surgical and analgesic protocols are needed to confirm these results.</p>