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Facial Plast Surg
DOI: 10.1055/a-2689-1496
Original Research

Comparative Outcomes of Septal Extension versus Columellar Strut Grafts for Nasal Tip Stabilization and Positioning in Rhinoplasty: A Systematic Review and Meta-analysis

Ismail Ozgenc 
1   School of Medicine, St George's University of London, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN4915)
2   School of Medicine, University of Nicosia Medical School, Nicosia, Cyprus (Ringgold ID: RIN486462)
,
Dana Alzoubi
2   School of Medicine, University of Nicosia Medical School, Nicosia, Cyprus (Ringgold ID: RIN486462)
,
Dilip Kumar Vankayalapati
3   Department of Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN6397)
,
Laith Ali Bayan
2   School of Medicine, University of Nicosia Medical School, Nicosia, Cyprus (Ringgold ID: RIN486462)
,
Sum-Yu Christina Lee
2   School of Medicine, University of Nicosia Medical School, Nicosia, Cyprus (Ringgold ID: RIN486462)
,
Kelson Huynh
2   School of Medicine, University of Nicosia Medical School, Nicosia, Cyprus (Ringgold ID: RIN486462)
,
Annah Waqasi
4   Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN5293)
,
Hayato Nakanishi
5   Department of Surgery, Mayo Clinic, Rochester, United States (Ringgold ID: RIN6915)
,
Annakan Victor Navaratnam
6   Otolaryngology, University College London Hospitals NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland (Ringgold ID: RIN8964)
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a. Introduction Columellar strut graft (CSG) and septal extension graft (SEG) are commonly used in septorhinoplasty for nasal tip support. b. Objective & Hypotheses We aimed to systematically review and compared CSG and SEG in achieving a desired nasolabial angle (NLA) and Goode’s ratio (GR). c. Study Design Several databases were systematically searched from inception to August 2024. Two-arm meta-analysis of the pooled means was conducted with a random-effects model. This review was registered in PROSPERO (CRD42024574909). d. Methods Eligible studies included primary septorhinoplasty patients (≥ 17 years) receiving CSG or SEG. e. Results Eight studies met eligibility criteria including 256 CSG and 371 SEG patients. Inter-group comparison of long-term post-operative NLA favored SEG (p < 0.05) while GR showed no differences. However, SEG patients had significant improvement in GR post-operatively (p < 0.05), unlike CSG patients. f. Conclusions SEG may provide superior long-term nasal tip rotation and projection stability.



Publication History

Received: 02 June 2025

Accepted after revision: 23 August 2025

Accepted Manuscript online:
25 August 2025

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