Background: Reconstruction of Nasal Tip Columella (NTC) subunits is one of the most challenging aspects in functional aesthetic rhinoplasty. Moreover, racial variation for Asian nose rhinoplasty could even demand sophistication of tip and columella strut graft infrastructure enhancement. Various autogenous graft options such as 6th costal cartilage, septal cartilage and conchal cartilage are very commonly considered whilst the 10th costal cartilage is scarcely reported. Objective and Method: The purpose of this manuscript is to illustrate the detailed operative steps to harvest the 10th costal cartilage for infrastructural grafting at NTC subunits by a case illustration. The pros and cons of different cartilage options will be discussed, particularly its application in cleft nose rhinoplasty in Chinese patient. We have adopted the 10th rib as the key option for NTC reconstruction in 11 cases of Chinese cleft secondary rhinoplasty since 2019 and have achieved good and stable results without complications. Conclusion: The 10th costal cartilage is one of the best options in Nasal Tip Columella subunits reconstruction, particularly in complex cleft nose or failure revision aesthetic rhinoplasty cases, due to its safety of harvesting, and the sufficient quality and quantity of grafting materials it provides for simultaneous adjunctive augmentation purpose.
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