Rhinoplasty Grafts: Surgical Utility Versus Patient-Perceived Aesthetic Impact

OBJECTIVES: In the present study, we investigated the efficacy of nasal tip grafts for nasal tip shaping and for evaluating rhinoplasty outcome evaluation (ROE). METHODS: Patients who underwent open rhinoplasty and received various grafts to improve tip support, including alar batten graft, alar rim graft, caudal septal extension graft, columellar strut, shield graft, tongue-in-groove, and tip-onlay graft, were included in this study (n=510). All follow-up items were recorded during the preoperative, early postoperative, and late postoperative periods. Rhinoplasty outcome evaluation scores, nasofrontal angle, and nasolabial angle were evaluated. RESULTS: A statistically significant difference was observed between the mean preoperative and postoperative questionnaire scores in the graft groups (P<0.001). Shield graft, tongue-in-groove, and tip-onlay graft groups showed better results than many others. A statistically significant difference was observed between the preoperative and postoperative mean nasolabial angle values in the tongue-in-groove, shield graft, caudal septal extension graft, and columellar strut groups (P<0.001). In addition, a statistically significant difference was found between the preoperative and postoperative mean nasofrontal angle values across the graft groups (P<0.001), with significant changes observed in the tongue-in-groove, shield, caudal septal extension, and columellar strut groups. However, these changes in the nasofrontal angle are considered not directly related to the type of graft used but rather to the dorsal hump reduction performed in these patients. CONCLUSION: These considerations underscore the limitation of attributing patient satisfaction solely to graft selection. They also highlight the importance of comprehensive preoperative counseling and multifactorial outcome assessment. Future studies using more controlled surgical variables or stratified analyses may help clarify the independent contribution of specific grafting techniques to both objective nasal angles and patient-perceived aesthetic success.