Surgical Pearls: Combined Septal Extension-Columellar Strut Graft for Rhinoplasty

Overview

Tip projection, rotation and support are core targets of rhinoplasty, and the two standard support grafts are usually used separately. The authors describe a combined graft made from the patient's own cartilage that joins both designs, intended to control tip position and shape while restoring strength to the tip. The article is presented in the journal's Surgical Pearls format, a brief description of a technique.

Sections of note

• Article type: surgical pearls, a description of a novel surgical technique.
• Setting: an academic practice.
• Participants are listed only as patients who underwent the operation, with no count given.
• Graft material: autologous cartilage, taken from the patient's own body.
• Stated aims: control tip projection, shape and rotation, and restore strength to the nasal tip.
• The abstract contains no results section, no outcome measures, no follow up period and no complication data.

What it means for a patient

• The two standard tip supports work differently. A septal extension anchors the tip to the septum, while a strut props it from below. Combining them is intended to get both effects.
• Nothing in the abstract shows whether the combined graft holds the tip better than either graft alone.
• No patient numbers, follow up or outcome scores are reported, so the technique cannot be evaluated from this record.
• Surgical pearls articles are descriptions of practice, not comparative evidence.

Why this paper matters

Loss of tip projection over the first year is a documented problem after rhinoplasty, and how best to support the tip remains an active disagreement. Combined graft designs are one response. Whether this combination adds stability, or simply adds stiffness and bulk, is not answered here.

Terms

• Septal extension graft: cartilage fixed to the septum that carries the tip in a set position.
• Columellar strut: a cartilage post placed between the nostrils to support the tip from below.
• Tip projection: how far the tip stands out from the plane of the face.
• Tip rotation: the upward or downward angle of the tip.
• Autologous cartilage: cartilage taken from the patient's own body.