Revision rhinoplasty for contracted nose: A systematic review and meta-analysis

Abstract

Background

This study aimed to review treatments and evaluate the aesthetic outcomes, complications, and reoperation rates regarding surgical correction for a postoperative contracted nose.

Methods

PubMed, MEDLINE, and Embase databases were searched for studies detailing aesthetic outcomes and complications of surgical correction of a contracted nose. Surgical procedures, adjuvant treatment, outcomes, and complications were synthesized and analyzed.

Results

Nine articles encompassing 376 patients were included in the systematic review, and six articles (198 participants) were included in the meta-analysis. The most frequently used graft material was the autologous rib cartilage (61.1%). Surgical procedures were heterogeneous in these studies. The nasolabial angle reduced by 9.52° (95% confidence interval (CI): (−11.95, −7.09), P<0.000 1), and the nasal length increased significantly (standardized mean difference (SMD)=2.25, 95% CI: (1.26, 2.23), P<0.000 01). However, the evidence was insufficient to determine a significant change in the columellar-labial angle (SMD=−0.95, 95% CI: (−2.19, 0.29), P=0.13) and columellar-lobular angle (SMD=2.39, 95% CI: (−1.20, 5.97), P=0.19). Aesthetic dissatisfaction (12.5%) and infection (4.5%) were the most commonly reported complications. Reoperation was performed in 5.3% of patients.

Conclusion

Surgical correction can increase the nasal length, reduce the nasolabial angle, and have a low reoperation rate. No significant improvement in the columellar-labial or columellar-lobular angle was observed.