Sublabial approach for columellar reconstruction in corrective rhinoplasty

Abstract

A novel technique is presented for columellar reconstruction via the sublabial approach, which is a challenging endeavor, both functionally and aesthetically. Patients with columellar collapse underwent columellar reconstruction via the sublabial approach. Following an upper gingivobuccal sulcus incision, a tunnel was created through which a cartilage graft, preferably septal, was introduced and fixed. An additional crescent-shaped graft was introduced to secure the fixed graft into position. Average operating time was 35 min for septal grafts and 55 min for conchal grafts. Postoperative complications were minimal. This approach is an anatomic, minimally invasive, time-saving procedure. The technique is easy to perform and can be rapidly mastered. It provides strong structural support, shape, height, and projection to the tip lobule via an inconspicuous scar. It is particularly advantageous in cases of previous septal operations and septal perforation and can be performed as a prophylactic measure in cases of poor tip support and when the anterior septum is severely deformed.