title: The effect of the columellar strut graft on nasal tip position in primary rhinoplasty.
abstract: BACKGROUND
  The columellar strut cartilage graft has historically been assumed to be a technique that increases tip projection. The purpose of this study was to retrospectively analyze a series of 100 consecutive rhinoplasty cases by the senior author (R.J.R.) with a specific focus directed toward the effect of the columellar strut on final tip position, namely, tip projection and tip rotation.
  
  
  METHODS
  Medical information and digital images were obtained from 100 consecutive primary rhinoplasty patients. All postoperative images were obtained from 1-year or greater follow-up visits. Preoperative and postoperative digital images were compared using a software application that quantitatively analyzed various facial anatomical features, including the nasofrontal angle, the nasolabial angle, tip projection, and tip translation.
  
  
  RESULTS
  Tip projection (defined as the tip position on the x axis) actually decreased in 65 percent, increased in 27 percent, and was unchanged in 8 percent of subjects. Tip translation (defined as the tip position on the y axis) was decreased in 59 percent, increased in 34 percent, and unchanged in 7 percent. The nasofrontal angle was increased in 67 percent, decreased in 23 percent, and unchanged in 10 percent of patients. The nasolabial angle was increased in 46 percent, decreased in 34 percent, and unchanged in 20 percent.
  
  
  CONCLUSIONS
  Use of the columellar strut cartilage graft does not necessarily imply an increase in tip projection, but rather serves as a means of unifying the nasal tip and helping to control final tip position.
authors.affiliation: Dallas and Wichita Falls, Texas; and Lyon, France From the University of Texas Southwestern Medical Center; private practice; and the University of Lyon.
authors.forename: Rod J
authors.initials: RJ
authors.lastname: Rohrich
authors.forename: T Jonathan
authors.initials: TJ
authors.lastname: Kurkjian
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Hoxworth
authors.forename: Phillip J
authors.initials: PJ
authors.lastname: Stephan
authors.forename: Ali
authors.initials: A
authors.lastname: Mojallal
mesh_terms: D002356:Cartilage / Q000637:transplantation*; D015331:Cohort Studies; D003936:Diagnosis, Computer-Assisted; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D060052:Nasolabial Fold; D009666:Nose / Q000601:surgery*; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D018570:Risk Assessment; D013536:Suture Techniques; D016378:Tissue Transplantation / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome