The ideal technique nasal tip surgery for Asians, understanding best technique, and post-operative improvement: Systematic review/meta-analysis.

INTRODUCTION: Asian nose is characterized by thick skin, abundant soft tissue, and weak cartilage framework, resulting in under-projection of the nasal dorsum and tip. Anatomical knowledge consideration is needed to achieve an ideal and natural-looking Asian nasal tip. Various nasal tip surgery techniques for Asian nose have been introduced recently. However, a comparison of techniques and postsurgical results has not yet been undertaken.

OBJECTIVE: This systematic review aims to highlight the basic understanding of nasal tip dynamics aesthetic Asian nose and analyze related studies in search for the best technique and post-operative improvement for Asian tip-plasty.

METHOD: Two independent reviewers conducted a comprehensive database search from four major medical databases (PubMed, Scopus, EBSCOhost, and EMBASE). Methodology quality and risk of bias in each study were assessed with the Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I tools).

RESULT: The initial literature search (May-July 2023) yielded 53 articles, of which 26 were removed (duplicated). The title and abstract screening reduced the count to 6 articles, and two were excluded for specific reasons. Finally, four articles were included in the systematic review and proceeded to methodological quality check and risk of bias assessment.

CONCLUSION: New techniques such as combining spreader graft, septal extension graft, and columellar strut graft for Asian tip-plasty show promising effect after surgery. Increasing nasal length, projecting the tip, and strengthening the nasal tip framework become key points for Asian tip-plasty.