Compared with autologous costal cartilage rhinoplasty, homologous costal cartilage rhinoplasty requires the same surgical procedures, but there is no need to harvest ribs from the patient; however, it is based on the proportionate homologous costal cartilage purchased from manufacturers, which not only curtails surgical duration but also avoids chest wall scars. At present, homologous costal cartilages that can be legally purchased in Taiwan are all imported from the US and are derived from legal organ donors. Such ribs have undergone multiple infectious disease and immunity examination procedures, deactivation by gamma rays, sterilization, and purification and would therefore not incur rejection reactions. The aforementioned procedures are approved by the Food and Drug Administration of the US (FDA) and the Taiwan Food and Drug Administration (TFDA) before application in human surgeries; therefore, the clinical application of homologous ribs is both safe and legal.
According to the guidelines of the TFDA, homologous costal cartilages are mainly used for the reconstruction of nasal congenital defects or traumatic deformities or for patients requiring revision due to the failure of a prior rhinoplasty. However, because the sources are limited and not constant, these ribs are very expensive due to the demand-over-supply market. Besides, the waiting period of the homologous ribs is not certain, patients may not schedule their surgeries freely like those receiving common rhinoplasties. Nevertheless, compared with autologous costal cartilages that still keep the memory of viable immunocytes, homologous ribs are free of any immunocytes or active cells after multiple treatments and are less likely to show self-warping, which lowers the probability of future revision. Moreover, the size and length of homologous ribs are pre-determined, which helps the physician and patient evaluate the expected surgical results. Since the size and length of the appropriate homologous ribs are variable, the physician needs to purchase them in line with patient requirements, so the cost and application are relatively different. Generally to say, homologous costal cartilages demonstrate a certain value in rhinoplasty and also enrich the sources of ribs for patients.
Homologous ribs should be stored in line with certain standards in specified devices. Our clinic is equipped with a −20°C medically dedicated refrigerator (tissue bank refrigerator), which preserves the homologous ribs purchased by patients for a long period to provide a sounder guarantee for surgical safety.