Three-Dimensional (3D) Columellar Strut Graft in Rhinoplasty

Topkara A.

What this paper says

In a retrospective series of 78 patients with mean follow-up of 15 months, a Y-shaped columellar strut graft was used to support the tip and all patients were reported satisfied with their tip shape.

Overview

Tip surgery is described by the author as the most important and most difficult part of an aesthetic rhinoplasty. Instead of a simple straight strut of cartilage between the nostrils, this technique uses a strut shaped like a Y when viewed horizontally, so its arms hold the two tip cartilages at the correct spacing.

Sections of note

All patients were treated using the open technique.
The graft is a three-dimensional dorsal columellar strut, described as Y-shaped on a horizontal plane.
Placed to maintain the interdomal angle, it stabilizes the lower lateral cartilages after they have been shaped with a cephalic dome suture.
Retrospective analysis of 78 patients who underwent the technique; mean follow-up 15 months.
All patients were reported satisfied with their tip shapes.
The author states the technique requires no additional cartilage graft in patients having the bridge reduced. Level of evidence 4.

What it means for a patient

The support piece under the tip can be shaped to set the spacing between the two tip cartilages, not just to prop the tip up.
In patients having a hump reduced, the cartilage removed can supply the graft, avoiding another harvest site.
Limits: 78 patients, one surgeon, retrospective, no comparison group, satisfaction reported without a stated measurement tool, and 15 months of follow-up.
A uniform report of satisfaction in every patient is unusual and should be read with the absence of an independent assessor in mind.

Why this paper matters

Tip support graft design determines whether the tip holds its shape and whether it looks natural from below. This adds a shaped variant to that toolkit. Without a comparison group or objective measurement, its advantage over a standard strut is not established here.

Terms

Columellar strut graft: A cartilage piece placed between the nostrils to support the tip.
Lower lateral cartilage: The paired cartilage forming the nasal tip and nostril rim.
Interdomal angle: The angle between the high points of the two tip cartilages.
Cephalic dome suture: A stitch placed at the upper part of the tip cartilages to refine their shape.
Open technique: Surgery using an external incision across the columella.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Nasal tip surgery is the most important and most difficult step of an aesthetic rhinoplasty operation. Various suture and grafting techniques have been described for adequate tip rotation and projection in nasal tip surgery. Objectives: The author describes his technique of "three-dimensional (3D) columellar strut…”

Excerpt; the full abstract is on PubMed.