The septal strut for nasal projection following closed rhinoplasty.
BACKGROUND
Nasal tip projection following closed rhinoplasty is difficult to predict and maintain.


OBJECTIVE
We describe a procedure using the septum as an autologous strut to preserve the stability of the nasal tip following closed rhinoplasty.


METHODS
Using an intra-cartilaginous approach for closed rhinoplasty, the medial cura of the lower lateral cartilages were dissected and attached to the septum. The septum was contoured prior to placement of the lower lateral cartilages to provide a stable tongue-and-groove joint.


RESULTS
Between January 2001 and December 2003, the author performed 123 closed primary rhinoplasty procedures. Septal struts were used in 76 patients. Adequate projection was maintained in 74 of 76 patients. No patient experienced an infection.


CONCLUSIONS
When properly prepared, the septum can provide a useful strut that will maintain adequate tip projection and prevent rotational changes following closed rhinoplasty.
Pensler
Jay M
JM