A Comparative Study of Columellar Strut and Septal Extension Grafts for Tip Support in Rhinoplasty

Background: Rhinoplasty is one of the most common aesthetic surgical procedures. Columellar strut and septal extension grafts are commonly used for tip support, but their long-term effectiveness and stability remain debated. This study aims to compare the long-term postoperative stability of these two techniques. Methods: A retrospective cohort study of patients underwent primary rhinoplasty using either columellar strut or septal extension grafts between March 2021 and March 2022 was conducted. Nasal tip projection and rotation stability were analyzed through photographic evaluations conducted preoperatively, as well as at 6 and 18 months postoperatively. Additionally, participant's satisfaction and the incidence of postoperative complications were assessed. Results: Both grafting techniques exhibited an initial increase in tip projection, followed by a slight regression at later stages. However, this change was not statistically significant for either group. A distinct difference emerged in tip rotation, as measured by the nasolabial angle. The columellar strut group experienced a notable increase in tip rotation initially, followed by a significant decrease, while the septal extension graft group exhibited minimal and statistically insignificant changes in tip rotation over the same period. Conclusion: Nasal tip rotation was more stable in cases with septal extension grafts compared to those with columellar strut grafts.