Three-dimensional (3D) Columellar strut graft in rhinoplasty

Abstract

Background: Nasal tip surgery is the most important and most difficult step of an aesthetic rhinoplasty operation. Various suture and grafting techniques have been described for adequate tip rotation and projection in nasal tip surgery. Objectives: The author describes his technique of "three-dimensional (3D) columellar strut graft" in nasal tip surgery. Methods: Each patient is treated using the open technique rhinoplasty. The author's technique uses a 3D dorsal columellar strut with a special anatomy in the shape of a Y- on a horizontal plane. When the dorsal columellar strut is placed in a way to maintain the interdomal angle, this technique perfectly stabilizes the lower lateral cruses (LLCs) that have been shaped with cephalic dome suture (CDS). Results: A retrospective analysis of 78 patients, who underwent 3D columellar strut graft technique, were included in the study. The mean follow-up period was 15 months. All of the patients were satisfied with their tip shapes. Conclusions: The 3D dorsal columellar strut graft technique is an easily administered technique with reliable outcomes. The purpose of this graft is to support the reshaped LLCs with a perfect anatomic alignment. It does not require any additional cartilaginous graft in patients undergoing a reduction of the dorsum.