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Abstract BackgroundComplex primary and secondary rhinoplasties usually necessitate grafting materials when native nasal cartilage is inadequate for reconstruction. Fresh frozen, aseptically processed, and nonterminally sterilized costal cartilage segment allografts (CCSAs) are a novel grafting material for such cases that avoid donor-site morbidity, improve operating efficiency, and mitigate the postoperative risks. ObjectivesTo report the early experience using fresh frozen, aseptically processed, and nonterminally sterilized CCSAs used in complex primary and secondary rhinoplasties, in Canada. MethodsWe retrospectively reviewed 21 patients (17 female and 4 male patients) who underwent a primary or secondary rhinoplasty surgery using CCSAs from June 2019 to April 2022. ResultsThe mean age was 39 years (range, 27-58 years), and the mean body mass index was 23.7 kg/m22 ConclusionsBased on early experience, this CCSA avoids donor-site morbidity and reduces operative time while maintaining a low complication rate, providing a viable alternative to the use of autologous costal cartilage when indicated in complex primary or secondary rhinoplasties with inadequate native nasal cartilage. Level of Evidence: 4