The septal strut for nasal projection following closed rhinoplasty

Nasal tip projection following closed rhinoplasty is difficult to predict and maintain.

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

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.

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.

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