A Novel Technique of Asian Tip Plasty: Rein-Shaped Columellar Strut Graft

Abstract

Background

The columellar strut graft is one of the most commonly used invisible grafts in tip plasty techniques for nasal tip projection. However, the columellar strut graft induces cephalic rotation of the dome with nasal tip projection. This is an effective change in Western people with a long nose; however, this change should be avoided in Asians who have a relatively short nose and visible nostrils. We designed a more convenient and effective technique using a rein-shaped columellar strut graft that can prevent cephalic rotation of the dome.

Methods

A total of 32 patients underwent surgery with a rein-shaped columellar strut graft with a septal cartilage. The projection and location of the nasal tip, nasal length, and nasolabial angle were measured after taking a photograph of the lateral view, and the preoperative and postoperative results were compared.

Results

There were statistically significant differences between the preoperative and postoperative values of the nasal tip projection ratio and nasal tip location ratio. There were no revision surgeries and no direct complications associated with the use of the columellar strut graft.

Conclusion

We performed tip plasty with a modified columellar strut graft—the rein-shaped columellar strut graft. In most cases of using this method, the tip projection was increased and the cephalic rotation of the tip was prevented. This surgical procedure can also be used for lengthening (rotating caudally) of the nose in some cases, as well as for the purpose of preventing the cephalic rotation of the tip.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

References

  1. 1.

    Rohrich RJ, Hoxworth RE, Kurkjian TJ (2012) The role of the columellar strut in rhinoplasty: indications and rationale. Plast Reconstr Surg 129(1):118e–125e

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    Kim CH (2015) A new concept in the tip plasty of Asian rhinoplasty: the flag technique by use of only a septal cartilage. Plast Reconstr Surg 135(4):1033–1036

    Article  CAS  PubMed  Google Scholar 

  3. 3.

    Petroff MA, McCollough EG, Hom D et al (1991) Nasal tip projection. Quantitative changes following rhinoplasty. Arch Otolaryngol Head Neck Surg 117(7):783–788

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    Dhong ES, Kim YJ, Suh MK (2013) L-shaped columellar strut in east Asian nasal tip plasty. Arch Plast Surg. 40:616–620

    Article  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Akkus AM, Eryilmaz E, Guneren E (2016) Varied definitions of nasolabial angle: searching for consensus among Rhinoplasty Surgeons and an algorithm for selecting the ideal method. Plast Reconstr Surg Glob Open. 4(6):e752

    Article  Google Scholar 

  6. 6.

    Falces E, Wesser D, Gorney M (1970) Cosmetic surgery of the non-Caucasian nose. Plast Reconstr Surg 45:317–325

    Article  CAS  PubMed  Google Scholar 

  7. 7.

    Matory WE, Falces E (1986) Non-Caucasian rhinoplasty: a 16-year experience. Plast Reconstr Surg 77:239–252

    Article  PubMed  Google Scholar 

  8. 8.

    Han SK, Lee DG, Kim JB et al (2004) An anatomic study of nasal tip supporting structures. Ann Plast Surg 52:134–139

    Article  PubMed  Google Scholar 

  9. 9.

    Li J, Huang Y, Zhang Y et al (2018) Application of a porous polyethylene spreader graft for nasal lengthening in Asian patients. Aesthet Surg J. https://doi.org/10.1093/asj/sjx216

    Article  PubMed  Google Scholar 

  10. 10.

    Guyuron B, Varghai A (2003) Lengthening the nose with a tongue-and-groove technique. Plast Reconstr Surg 111(4):1533–1539

    Article  PubMed  Google Scholar 

  11. 11.

    Han K, Kim J, Son D et al (2008) How to harvest the maximal amount of conchal cartilage grafts. J Plast Reconstr Aesthet Surg 61:1465–1471

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Man-Koon Suh.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kim, H.I., Lee, W.J., Roh, T.S. et al. A Novel Technique of Asian Tip Plasty: Rein-Shaped Columellar Strut Graft. Aesth Plast Surg 43, 1301–1309 (2019). https://doi.org/10.1007/s00266-018-1185-z

Download citation

Keywords

  • Rhinoplasty
  • Nasal tip
  • Columellar strut