Triangular Fossa Cartilage Graft in Rhinoplasty: A Three-Dimensional Anatomical and Technical Feasibility Study

Summary: Aesthetic rhinoplasty relies on a stable framework for long-term structural integrity, often requiring autogenous cartilage grafts. While conchal cartilage is commonly used, its volume may be insufficient, particularly in secondary or revision rhinoplasty. This study presents a novel technique for simultaneous harvesting of triangular fossa cartilage through the same posterior auricular incision as the conchal graft. This approach increases available graft material without requiring additional donor sites, minimizing morbidity while preserving auricular aesthetics. A retrospective analysis of 14 patients (15 ear donor sites) was conducted to evaluate postoperative auricular morphology using three-dimensional (3D) imaging. Patients were classified into three groups: conchal cartilage only, conchal + triangular fossa cartilage without helix crux preservation, and conchal + triangular fossa cartilage with helix crux preservation. Postoperative 3D analysis demonstrated no significant differences in ear height, width, or conchal cavity dimensions. A mild reduction in triangular fossa area was observed but did not result in visible deformity or functional impairment. Preservation of the helix crux maintained the natural curvature of the antihelix, ensuring donor site stability. This technique provides an effective alternative for cases requiring additional cartilage, particularly in revision rhinoplasty and structural augmentation. By expanding graft availability through a single incision, it enhances surgical efficiency while maintaining a natural ear contour. Future studies incorporating long-term follow-up and patient-reported outcomes will further validate its role in clinical rhinoplasty.