Internal Nasal Dilators After Septorhinoplasty: A Randomized Controlled Trial of Functional and Aesthetic Outcomes

BACKGROUND: Postoperative nasal obstruction and asymmetry can compromise satisfaction after rhinoplasty. Internal nasal dilators (INDs) may support early healing by maintaining valve patency and symmetry, but their postoperative efficacy has not been systematically evaluated. OBJECTIVES: The aim of this study was to determine whether IND use after septorhinoplasty improves functional, aesthetic, and symmetry outcomes compared with standard care. METHODS: In this single-center, randomized, single-blinded trial, 128 adults undergoing primary septorhinoplasty were allocated (1:1) to IND plus standard care or standard care alone. Assessments were performed at baseline, 3 months, and 12 months using the validated Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) and a nostril-symmetry item (0 = perfect, 4 = very asymmetrical). The primary outcome was patient-reported nostril symmetry; secondary outcomes included functional and aesthetic SCHNOS scores, comfort, and adverse events. RESULTS: Baseline characteristics were comparable. Nostril-symmetry scores favored the IND group at 3 months (0.78 ± 0.92 vs 1.42 ± 1.09; P = .001) and 12 months (0.46 ± 0.71 vs 1.40 ± 1.20; P < .001). Functional SCHNOS improved in both groups, with a slightly greater gain in the IND group at 12 months (+10.2 ± 4.1 vs +7.9 ± 4.4; P = .048). Aesthetic SCHNOS scores improved similarly across groups (P = .73). Device comfort was high, as measured by a visual analog scale (VAS 8.1 ± 1.4/10), and no device-related complications occurred. CONCLUSIONS: INDs improved postoperative nostril symmetry and maintained favorable functional and aesthetic outcomes without added risk or discomfort. These findings support the adjunctive use of INDs to enhance symmetry and patient satisfaction after rhinoplasty. LEVEL OF EVIDENCE: 2 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.