Evaluation of the Goldman tip procedure in modern-day rhinoplasty.

OBJECTIVES To present a critical review of a single surgeon's long-term results using the Goldman tip procedure and to examine the current attitudes of a select group of experienced rhinoplasty surgeons concerning the Goldman tip procedure. DESIGN A retrospective review was conducted of the medical records of all patients who underwent a Goldman tip procedure performed by the senior author (R.L.S.) between 1975 and 2001. Demographic data, long-term outcomes (minimum follow-up, 1 year), complications, and surgeon-patient satisfaction were analyzed. Also, surveys were mailed to a select group of 50 experienced rhinoplasty surgeons. The survey recipients were asked about their current use of the Goldman tip procedure and any concerns about the technique. RESULTS A total of 166 cases were eligible for analysis. The mean age of the patients was 33.7 years, and a large percentage of the patients (43.4%) were male. The overall complication rate was 5.4%, with a revision rate of 1.2%. The survey response rate was 78% (39/50). Of the respondents, 14 (41%) are still using the Goldman tip procedure in their practice, although most of them use the technique relatively infrequently. The most common concerns regarding the procedure were unnatural appearance (41%), thin skin (13%), and adverse functional sequelae (8%). Nearly one third of the respondents had no major concerns about using the technique. CONCLUSIONS The Goldman tip procedure is a safe, effective technique for a select group of patients. A polling of experienced rhinoplasty surgeons revealed that only a small subset of surgeons support the continued viability of the Goldman technique as a surgical option.