More specifically for rhinoplasty, Kridel and Konior2 described the largest series so far, with 122 rhinoplastic procedures in which 306 IHRGs were used. In their study, the follow-up ranged from 1 to 84 months, with an average of 15 months. Complete resorption was noted for 2 grafts (both in the same patient). This total resorption was found early in the postoperative phase and resulted from a localized infection at the graft site. Partial resorption (0%-25%) was seen in 2 patients, both cases involving a dorsal onlay graft. Murakami et al4 described a series of 18 patients with saddle nose deformities. Reconstruction was performed using IHRGs, a dorsal onlay graft attached to a collumelar strut. Follow-up ranged from 1 to 6 years (mean, 2.8 years), and none of the IHRGs showed infection, extrusion, or noticeable resorption. Burke et al10 studied 118 patients who had undergone nasal reconstruction in which a total of 177 IHRGs were used. Four of 13 patients (30%) with follow-up of 5 to 10 years had severe to complete loss of graft volume (51%-100% resorption), whereas 2 of 3 patients (66%) with follow-up of more than 10 years showed this volume reduction. Loss of structural support with compromised nasal function or aesthetics for the same follow-up periods occurred in 3 of 14 patients (21%) and in 1 of 3 patients (33%), respectively. Burke and colleagues10 also studied the long-term outcome of IHRGs for auricular reconstruction and found resorption in 5 of 7 patients (71%). The typical appearance was an amorphous mass, which was probably due to the replacement of the original grafts by fibrous tissue. The IHRGs from our series were obtained from Tutoplast. Because these grafts were chemically processed with peroxide and acetone before irradiation, they might not behave the same as nonchemically processed irradiated rib grafts. Irradiated homologous rib grafts from the same manufacturer were used to augment the nasal dorsum as dorsal onlay grafts, or they were diced and wrapped in oxidized cellulose (Surgicel; Johnson & Johnson, New Brunswick, New Jersey). With a mean follow-up of 36 months, recurrence of dorsal depression was observed in 5 of 23 patients (22%). This recurrence was probably attributable to partial resorption.18 Song et al19 noted partial resorption of dorsal onlay grafts in 6 of 35 cases (17%). Our study was intended to assess which types of nasal grafts were reliable for a favorable long-term functional and aesthetic outcome. In the evaluation of the resorption rate, the amount of volume and support function were taken into account. Both parameters were evaluated in a subjective manner, but with the use of the classification system described in the “Methods” section, we studied and analyzed the results as objectively as possible. As we stated earlier, the rate of complete resorption in our series was low. Only a shield graft was completely resorbed. In that case, palpation confirmed the presence of graft tissue underneath the overlying soft-tissue envelope, with a reduction of tissue consistency compared with the original IHRG graft. The incidence of moderate resorption, on the other hand, increased with duration of follow-up to levels of 49% in patients with follow-up of 71 to 96 months. However, the clinical consequences of resorption were different for the distinct types of nasal IHRGs used. Nasal IHRGs with a need for structural support were more likely to lose their function. Shield grafts for increasing nasal tip projection were most at risk. In cases of moderate resorption, these grafts showed less tissue consistency during palpation. Clinically, the nasal tip in these cases showed a loss of tip definition and refinement and became more bulbous in comparison with the situation 3 months after surgery. Consequently, there was minimal loss of nasal tip projection. Columellar struts and caudal septal replacement grafts were clearly less rigid on palpation, but, in general, there was little to no loss of projection. In time, IHRG dorsal onlay grafts were also found to have lost tissue consistency on palpation, but the contour was generally well preserved. In all cases involving alar batten grafts, the implants were palpable and showed some reduction of tissue consistency. However, improvement of nasal breathing was achieved in 37 of 40 cases (92%). Improved nasal passage with spreader grafts was found in 4 of 4 cases (100%).