Current Surgical Outcomes of Nasal Tip Grafts in Rhinoplasty: A Systematic Review

Background: Refinement of the nasal tip plays an important role in rhinoplasty surgery outcomes and may be considered the most technically challenging aspect of the procedure. Numerous techniques have been described for nasal tip augmentation utilizing grafts. The aim of this study was to systematically review the existing literature on nasal tip grafts and critically appraise it. Methods: A PubMed search was performed to identify journal articles related to nasal tip grafts from the last decade. A total of 44 studies met inclusion criteria. The Newcastle-Ottawa Quality Assessment Scale (NOQAS) and Jadad Scale were used to appraise 38 observational studies and six randomized trials, respectively, to determine the quality of the studies. Results: Critical assessment revealed that the studies were highly variable in focus and encompassed autologous, homologous, and alloplastic grafts. The quality of the data included an average NOQAS score of 6.5 (out of 9) and Jadad score of 2.5 (out of 5). A majority (86.4%) of studies included objective outcomes via anthropometric measurements and a portion (27.3%) of studies also included patient-reported outcomes. Conclusions: The results of this systematic review suggest that more than one type of nasal tip graft may result in satisfactory outcomes. This review provides an expansive collection of studies on nasal tip grafts which serves as an invaluable tool to the plastic surgeon engaging in rhinoplasty.