Purpose: The purpose of this study was to evaluate the efficacy and safety of combining Platelet-Rich Fibrin (PRF) with Diced Cartilage (DC) in patients undergoing rhinoplasty. Methods: A systematic search of MEDLINE/PubMed, Cochrane Library, Web of Science, and Scopus was conducted, including studies published through August 9, 2024. We included observational studies and clinical trials of rhinoplasty using the DC technique with PRF. Primary outcomes were cartilage resorption, nasal dorsum/tip irregularity, and patient satisfaction. Secondary outcomes included postoperative complications such as edema, hematoma, infection, erythema, displacement, and extrusion. Risk of Bias (ROB) was assessed using the ROB2 tool for randomized trials and the MINORS checklist for observational studies. Results: Seven studies with 286 participants were included. Results showed minimal cartilage resorption in five studies. T he pooled incidences of nasal dorsum/tip irregularity, erythema, and displacement were 0.43% [95% CI: 0.00-1.95%], 1.63% [95% CI: 0.00-4.99%], and 0.63% [95% CI: 0.00-2.22%], respectively. Patient satisfaction was high, with a pooled rate of 94.33% [95% CI: 89.28-99.38%]. Conclusion: The addition of PRF to DC in rhinoplasty was associated with favorable postoperative outcomes and high patient satisfaction, with a low incidence of complications. However, the lack of comparative studies makes it difficult to determine whether PRF provides significant benefits over DC alone. Larger randomized controlled trials with longer follow-up are needed to further validate these findings.

Salmah Muidh Ali Alharbi is board certified otolaryngologist, active member of Saudi society of ORL, active member of American College of Surgeons and an ATLS instructor with multiple publications.