Patient and Observer Graded Rhinoplasty Scar Outcomes: A Randomized Controlled Trial of Fast Absorbing Versus Permanent Columellar Suture Closure

Jonas RH, Patel KG, Rist TM, Walker ER, Oyer SL.

What this paper says

In a randomized trial of 41 open rhinoplasty patients, dissolving stitches and non dissolving stitches produced no detectable difference in the columellar scar, rated by both patients and a blinded surgeon.

Overview

Surgeons commonly close the columellar incision in open rhinoplasty with non absorbable skin sutures, believed to minimize scarring, but removing them causes discomfort and the resulting scar may be no better than with absorbable stitches. This prospective randomized controlled trial compared scar appearance between the two suture types.

Sections of note

Prospective randomized controlled trial with 61 patients enrolled.
Forty one patients completed follow up and were included in the final analysis.
Twenty three had absorbable sutures and 18 had non absorbable sutures.
A blinded surgeon rated each scar using the Stony Brook Evaluation Scale.
Each patient completed the Patient Scar Assessment Questionnaire.
The results did not reject the null hypothesis of no difference between suture types on either measure.
The authors conclude no difference was detected in scar outcomes as rated by either patients or blinded clinicians.

What it means for a patient

Dissolving stitches avoid a suture removal appointment and its discomfort without apparently costing scar quality.
Both a blinded clinician and the patients themselves rated the scars, which strengthens the comparison.
Twenty of 61 enrolled patients did not complete follow up, which is a substantial loss.
With 41 patients, a small real difference could go undetected; failing to find a difference is not proof there is none.

Why this paper matters

The columellar scar is the visible cost of the open approach and the main argument used against it. This trial tests whether suture choice affects that scar, using randomization and blinded assessment. Its size limits the confidence that can be placed in the negative result.

Terms

Columellar incision: the cut across the strip of skin between the nostrils in open rhinoplasty.
Absorbable suture: a stitch the body breaks down, requiring no removal.
Non absorbable suture: a permanent stitch that must be removed.
Stony Brook Evaluation Scale: a scored clinician assessment of scar appearance.
Patient Scar Assessment Questionnaire: a validated patient rating of their own scar.
Null hypothesis: the assumption of no difference, which a trial attempts to disprove.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“When performing an open rhinoplasty, surgeons commonly use nonabsorbable skin sutures to close the columellar incision. These are believed to minimize scarring. However, removal can be associated with patient discomfort and outcomes may not be superior to using absorbable sutures. Objective: To compare difference in…”

Excerpt; the full abstract is on PubMed.