Contemporary review of rhinoplasty

Overview

The authors set out to summarize what the rhinoplasty literature of roughly 2002 to 2012 established. They focus on evidence for functional rhinoplasty, valve and septal surgery, and on key articles about tip shaping, bone cuts, imaging and the various implant materials, noting that outcome data increasingly drive reimbursement and physician rating.

Sections of note

• Narrative review of the past decade; no new patient data are reported in the abstract.
• Evidence reviewed for functional rhinoplasty, nasal valve surgery and septal reconstruction.
• Key articles on cephalic malposition of the lower lateral cartilages and tip contouring.
• Studies on lateral osteotomy techniques and computer imaging.
• Use of homologous, alloplastic and absorbable implants.
• Outcome data from key studies are reviewed where available because of their growing role in evidence-based medicine, physician grading and procedure reimbursement.

What it means for a patient

• Breathing surgery on the nose has an evidence base that insurers and regulators increasingly look at.
• The review gives an overview of which techniques had supporting data as of 2012, but the abstract does not state any results.
• A narrative review reflects the authors' selection of key papers rather than a systematic search.

Why this paper matters

It is a snapshot of the field from a leading structural rhinoplasty group at the moment outcome measurement was becoming mandatory. Its conclusions predate the preservation rhinoplasty and piezo era. Specific findings are not given in the abstract.

Terms

• Functional rhinoplasty: nasal surgery aimed at improving breathing.
• Nasal valve: the narrowest part of the airway, prone to collapse.
• Cephalic malposition: tip cartilages rotated upward from their normal position, giving a bulbous tip and weak nostril rim.
• Lateral osteotomy: the bone cut along the side of the nose used to narrow it.
• Homologous implant: donor tissue from another person, such as irradiated rib cartilage.
• Alloplastic implant: a manufactured synthetic implant such as silicone or porous polyethylene.