title: Revisiting the role of columellar strut graft in primary open approach rhinoplasty.
abstract: BACKGROUND
  The effect of a columellar strut graft on final nasal tip position has been a subject of ongoing debate. The purpose of this study was to retrospectively analyze a series of 100 consecutive primary rhinoplasty cases performed without the use of columellar strut grafts, with a specific focus directed toward comparing preoperative, morphed, and actual postoperative changes in nasal tip position.
  
  
  METHODS
  Data were collected from patient charts and digital images of 100 consecutive primary open rhinoplasty patients. Preoperative, morphed, and actual postoperative digital images were quantitatively analyzed using image-processing software to compare various anatomical features, including nasal tip projection, nasolabial angle, and Goode ratio. Patient satisfaction regarding long-term postoperative results was also surveyed.
  
  
  RESULTS
  Primary rhinoplasty did not demonstrate a universal trend toward either an increase or a decrease in nasal tip projection. The planned changes in nasal tip projection, nasal tip rotation, and nasal profile proportions were obtained with statistically significant accuracy without the use of columellar strut grafts. The overall incidence of columellar contour irregularities was 3 percent.
  
  
  CONCLUSIONS
  In primary open approach rhinoplasty, if native anatomical support structures of the nasal tip are preserved or reconstructed, preoperative goals regarding nasal tip projection, nasal profile proportions, and columellar integrity can be consistently achieved without using columellar strut grafts.
authors: Ankara, Turkey; and Cleveland, Ohio From the Department of Plastic Surgery, Hacettepe University Faculty of Medicine; and the Section of Cosmetic Surgery, Cleveland Clinic Foundation.
authors: Ozan
authors: O
authors: Bitik
authors: Hakan
authors: H
authors: Uzun
authors: Haldun O
authors: HO
authors: Kamburoğlu
authors: Mert
authors: M
authors: Çaliş
authors: James E
authors: JE
authors: Zins
mesh_terms: D000293:Adolescent; D000328:Adult; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods*; D055815:Young Adult