Journal archive · Nasal tip · Open versus closed approach · Anatomy and nasal analysis · 2023
Columellar Scar Following Open Rhinoplasty Using Absorbable Suture Versus Nonabsorbable Suture: A Meta-Analysis
Kenny H, Jonas RH, Oyer S.
What this paper says
Pooling six studies with 435 patients, the columellar scar after open rhinoplasty looked the same in the long term whether it was closed with absorbable or non-absorbable sutures, by both patient and surgeon ratings.
Overview
Absorbable sutures save the patient a suture-removal visit; non-absorbable sutures are traditionally thought to give finer scars. The authors searched PubMed, OVID Medline, Conference Papers Index, Web of Science, Cochrane and ClinicalTrials.gov and pooled the comparative studies.
Sections of note
- Six studies, 435 patients, in the systematic review.
- Five studies pooled for patient-reported scar outcomes; six for physician-reported.
- No significant difference in scar appearance between suture types for either patient or physician ratings.
- Search terms covered columellar, transcolumellar, rhinoplasty, septorhinoplasty and scar variants.
What it means for a patient
- The type of stitch used on the columella does not appear to affect how the scar ends up looking.
- Absorbable sutures avoid the discomfort of removal at about one week.
- Six studies is a small evidence base.
Why this paper matters
It answers a routine practical question with the available comparative data. Limits: few studies, varied scar scales, follow-up durations not stated in the abstract.
Terms
- Absorbable suture: a stitch that dissolves on its own over days to weeks.
- Non-absorbable suture: a stitch (often nylon or polypropylene) that must be removed.
- Columellar incision: the external cut across the columella in open rhinoplasty.
- Meta-analysis: a statistical pooling of results from several studies.
Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows. All 1,262 summaries.
From the abstract
“This meta-analysis seeks to determine whether a difference in long-term scar outcomes exists between absorbable and nonabsorbable sutures for closure of the columellar incision after open rhinoplasty. Review Methods: PubMed, OVID Medline, Conference Papers Index, Web of Science, Cochrane Library, and…”
Excerpt; the full abstract is on PubMed.
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Nasal tip
Tip surgery is now a support problem rather than a sculpting problem: the septal extension graft holds projection and rotation where the columellar strut loses them (0.2% against 4.7% projection loss at one year), and the current series repair, reposition and reinforce the lower lateral cartilages instead of excising them.
Open versus closed approach
Whether the surgeon opens the nose through a small incision across the columella or works entirely through the nostrils has been argued in print since 1973, was put on facing pages of Plastic and Reconstructive Surgery by Jack Gunter and Jack Sheen in 1997, and was finally pooled in 2025: across twenty studies and 1,067 patients there is no significant difference in what patients report, in breathing, in complications or in swelling.
Anatomy and nasal analysis
Before any technique is chosen, the nose has to be read: the bone measured, the cartilage counted, the skin assessed, and the result the patient wants agreed on a photograph that is not yet true.
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