Unmasking the Risk of Vaping-Associated Pneumothorax in Rib Cartilage Rhinoplasty

Rib cartilage grafting is a popular procedure for rhinoplasty due to its advantages of zero foreign material involvement and minimal to near zero risk of skin perforation. However, there are some potential risks associated with this procedure, including warping and pneumothorax. Even though multiple studies have stated that the incidence rate of pneumothorax in rib graft harvest is very low, we cannot neglect its reality and probability of it happening. In this article, we highlight two rare cases of pneumothorax in rib cartilage graft rhinoplasty. The first case involved a pneumothorax that occurred during rib cartilage harvest in a 37-year-old woman. The second case involved a spontaneous pneumothorax that occurred immediately after rib cartilage rhinoplasty surgery in a 46-year-old woman. Both pneumothoraces were managed successfully with conservative observation and chest tube placement, respectively. The patients made a full recovery and were able to return to their normal activities. One of the potential risks of pneumothorax is the use of e-cigarettes or vaping. Vaping-associated spontaneous pneumothorax has been reported in only a handful of studies. These cases highlight the importance of being aware of the potential risks of rib cartilage graft rhinoplasty and taking steps to minimize and manage them.