L-Shaped Columellar Strut in East Asian Nasal Tip Plasty

• Main Authors: Eun-Sang Dhong, Yeon-Jun Kim, Man Koon Suh
• Format: Article
• Language: English
• Published: Korean Society of Plastic and Reconstructive Surgeons 2013-09-01
• Series: Archives of Plastic Surgery
• Subjects: Rhinoplasty; Nasal septum; Treatment outcome
• Online Access: http://www.e-aps.org/upload/pdf/aps-40-616.pdf

BackgroundNasal tip support is an essential consideration for rhinoplasty in East Asians. There are many techniques to improve tip projection, and among them, the columellar strut is the most popular technique. However, the conventional design is less supportive for rotating the tip. The amount of harvestable septal cartilage is relatively small in East Asians. For an optimal outcome, we propose an L-shaped design for applying the columellar strut.MethodsTo evaluate the anthropometric outcomes, the change in nasal tip projection and the columella-labial angle were analyzed by comparing preoperative and postoperative photographs. The anthropometric study group consisted of 25 patients who underwent the same operative technique of an L-shaped strut graft using septal cartilage and were followed up for more than 9 months.ResultsThere were statistically significant differences between the preoperative and postoperative values in the nasal tip projection ratio and columella-labial angle. We did not observe any complications directly related to the L-shaped columellar strut in the anthropometric study group.ConclusionsThe L-shaped columellar strut has advantages not only in the controlling of tip projection and rotation, but in that it needs a smaller amount of cartilage compared to the conventional septal extension graft. It can therefore be an alternative technique for nasal tip plasty when there is an insufficient amount of harvestable septal cartilage.