Ahmet ARSLANOĞLU, Erdi ÖZDEMİR
European Journal of Rhinology and Allergy - 2026;9(2):91-97
Objective: Shield grafts are widely used in rhinoplasty to improve nasal tip projection, definition, and overall aesthetic harmony. However, objectively assessing their contribution remains challenging. This study aimed to evaluate the aesthetic impact of shield graft application using the Integrated Nasal Tip Aesthetic Score (INTAS), a multidimensional scoring system combining objective measurements, patient-reported outcomes, and independent observer evaluations. Methods: A retrospective cohort of 60 consecutive patients who underwent rhinoplasty with Modified Extended Shield Graft placement was analyzed. Variables included demographic characteristics, graft material, INTAS scores, Rhinoplasty Outcome Evaluation (ROE) scores, blinded evaluator assessments, patient satisfaction, and postoperative complications. Preoperative and postoperative outcomes were compared using paired statistical analyses. Furthermore, multivariable regression models were used to identify the anatomical predictors that most strongly correlated with improved aesthetic scores after graft placement. The results indicated a statistically significant improvement in overall aesthetic metrics across the cohort, with specific graft dimensions showing a strong correlation with enhanced nasal tip definition. Results: The mean age of the cohort was 28.9 +/- 7.4 years. Significant improvements were observed in all aesthetic outcome measures. INTAS total scores improved from 22.6 +/- 5.3 preoperatively to 46.2 +/- 4.8 postoperatively (p < 0.001). ROE scores increased from 4.3 +/- 1.6 to 8.6 +/- 1.1 (p < 0.001). Independent evaluator scores demonstrated substantial improvement in nasal tip aesthetics. Patient satisfaction was high (8.9 +/- 1.0/10). Complications occurred in 6.7% of patients, while revision surgery was required in only 3.3%. Conclusion: In this present study, shield grafts demonstrated a substantial positive effect on nasal tip aesthetics, projection, and patient satisfaction. INTAS appears to be a useful multidimensional tool for evaluating nasal tip outcomes following rhinoplasty.
