Grafts Are Superior to Sutures for Nasal Tip Projection: A Meta-analysis of Goodes Ratio

Objectives:(1) Discuss relevant tip projection ratios involved in surgical planning of rhinoplasty. (2) Implement findings of meta-analysis in cosmetic surgery planning.Methods:Meta-analysis of journal articles through June 2013. Intervention: Cosmetic rhinoplasty for underprojected tip. Outcome Measurements: Pre- and postoperative Goode Ratio in cosmetic rhinoplasty patients. Null hypothesis: None of 3 techniques provides superior tip projection among: suture, internal graft, and external graft.Results:External graft techniques, such as Sheen shield grafting, were found to significantly increase tip projection over suture only techniques. External vs suture: P = .017. (2) Internal graft techniques, such as columellar strut grafting, approached significance in increased tip projection over suture only technique. Internal vs suture: P = .053. (3) Internal and external graft techniques did not differ significantly, but external graft techniques displayed a tendency to increase tip projection more. External ...