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Background <p>Rhinoplasty is a common plastic surgery, with nasal tip support being vital for optimal aesthetic outcomes. The Columellar Strut Graft (CSG) and Septal Extension Graft (SEG) are widely used, but comparative evidence on their long-term efficacy remains limited. This meta-analysis evaluates and compares the long-term outcomes and safety of CSG versus SEG in rhinoplasty.</p> <p>We aimed to compare the long-term stability of nasal projection and rotation between CSG and SEG techniques.</p> Methods <p>A comprehensive search of PubMed, Cochrane Library, Scopus, Embase, and Web of Science was conducted through December 2024. Both randomized and non-randomized studies comparing CSG and SEG were included. Key outcomes assessed included nasolabial angle (NLA), NAT angle, AT/AN ratio, Goode ratio, nasal tip projection, and postoperative complication rates. A fixed-effects meta-analysis was used to pool data, reporting weighted mean differences (WMD) and odds ratios (OR).</p> Results <p>Seven studies involving 727 patients were identified, with data from 4 studies (<i>n</i> = 470) contributing to the meta-analysis. SEG demonstrated significantly better long-term rotational stability, with reduced loss of the nasolabial angle compared to CSG (WMD: -4.40; 95% CI: -7.20 to -1.60; <i>P</i> = 0.002). No significant differences were found in nasal tip projection or complication rates between the two techniques.</p> Conclusions <p>SEG provides superior long-term stability in nasal tip rotation without affecting projection or increasing complication risks. These results support the preferential use of SEG in rhinoplasty while highlighting the importance of further research on patient-specific surgical outcomes. Level of Evidence: Not ratable</p>

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Comparing long-term nasal projection and rotation outcomes in rhinoplasty: a systematic review and meta-analysis of columellar strut graft versus septal extension graft

  • 期刊论文

  • 发表日期：

    2025年7月30日

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  • Yahya A. Mahmoud,
  • George Jabrieh,
  • Hussein Mohammed Dawoud,
  • Nouran Samy Sallam,
  • Abdelrahman Salah Mohamed,
  • Shrouk Eladawi,
  • Toya Khaled Shalkamy,
  • Ibrahim Moqbel

摘要

Background

Rhinoplasty is a common plastic surgery, with nasal tip support being vital for optimal aesthetic outcomes. The Columellar Strut Graft (CSG) and Septal Extension Graft (SEG) are widely used, but comparative evidence on their long-term efficacy remains limited. This meta-analysis evaluates and compares the long-term outcomes and safety of CSG versus SEG in rhinoplasty.

We aimed to compare the long-term stability of nasal projection and rotation between CSG and SEG techniques.

Methods

A comprehensive search of PubMed, Cochrane Library, Scopus, Embase, and Web of Science was conducted through December 2024. Both randomized and non-randomized studies comparing CSG and SEG were included. Key outcomes assessed included nasolabial angle (NLA), NAT angle, AT/AN ratio, Goode ratio, nasal tip projection, and postoperative complication rates. A fixed-effects meta-analysis was used to pool data, reporting weighted mean differences (WMD) and odds ratios (OR).

Results

Seven studies involving 727 patients were identified, with data from 4 studies (n = 470) contributing to the meta-analysis. SEG demonstrated significantly better long-term rotational stability, with reduced loss of the nasolabial angle compared to CSG (WMD: -4.40; 95% CI: -7.20 to -1.60; P = 0.002). No significant differences were found in nasal tip projection or complication rates between the two techniques.

Conclusions

SEG provides superior long-term stability in nasal tip rotation without affecting projection or increasing complication risks. These results support the preferential use of SEG in rhinoplasty while highlighting the importance of further research on patient-specific surgical outcomes. Level of Evidence: Not ratable