Post‐Operative Infection in Rhinoplasty With Autologous Versus Cadaveric Costal Cartilage Grafting

OBJECTIVE: To determine if post-operative infection rates after rhinoplasty differ based on use of autologous versus irradiated cadaveric costal rib grafting and use of prophylactic antibiotics. METHODS: Patients undergoing cosmetic or functional rhinoplasty or nasal valve repair with costal cartilage grafting during the years 2002-2025 were identified. Patients were separated into those who underwent autologous rib grafting versus irradiated homologous (cadaveric) costal cartilage grafting. Demographic data, rates of post-operative prescription of oral or IV antibiotics from post-operative day three to 30, and rates of return to OR for revision within the first 30 post-operative days were tabulated for each group and compared with chi-square and Fisher Exact tests. RESULTS: A total of 707 patients who underwent rhinoplasty with costal cartilage grafting were identified; 422 with autologous rib grafting (54% female; median age 48 years) and 285 with cadaveric costal cartilage grafting (52.6% female; median age 53 years). The rate of post-operative infection did not significantly differ between the autologous and cadaveric rib groups (2.3% vs. 2.3%, p = 0.99). One patient in the cadaveric group (0.34%) returned to the operating room for revision (washout of post-operative infection) within the first 30 post-operative days. Prescription of post-operative oral prophylactic antibiotics did not significantly decrease the post-operative infection rate (p = 0.13 for autologous group and p = 0.18 for cadaveric group). CONCLUSION: Post-operative infection rates after rhinoplasty did not significantly differ between patients undergoing cadaveric versus autologous rib grafting. The use of prophylactic antibiotics did not decrease the risk of post-operative infection.