Control of Nasal Tip Position in Thick Skin Population. Columellar Graft Versus Septal Extension Grafts in Open Rhinoplasty

Abstract

Background: Maintaining the position of the nasal tip is a crucial aspect of rhinoplasty. Objectives:To analyze the preservation of tip projection and rotation resulting from the utilization of either a columellar strut or a septal extension graft, which are two commonly employed techniques for achieving tip control aiming to reach a more predictable pre-operative planning. Patients and Methods:In this comparative clinical study, 40 candidates divided equally in two groups A for Columellar strut and Group B for Septal extension graft (16 women; 24 men; average age, 27 years) for primary rhinoplasty between October 2020 to October 2022 were included.Undergoing rhinoplasty computer software was used to analyze the effect columellar strut or septal extension graft on tip projection and rotation.Patients that need revision rhinoplasty or patients with congenital nasal problems were excluded.Results: Most cases 21 (52.5%) were presented with deviated dorsum septum.Columellar strut and Septal Extension graft group, comparison between immediate post-operative and 6-month post-operative revealed significant p-value regarding tip projection and tip rotation.Conclusions: From the immediate postoperative position, nasal tip projection and rotation seem to have decreased.The tip projection and rotation of patients with columellar strut and those with septal extension graft both exhibit the same changes with no significant differences between both groups when followed-up for 6 months postoperative.