Enhancing Nasal Tip Control: The Role of Septum Anchorage Sutures in Modern Rhinoplasty

Overview

The Colombian authors reviewed 1,096 consecutive patients treated with primary endonasal rhinoplasty using the septocolumellar suture between March 2005 and March 2025. The suture anchors the medial crura to the caudal septum at a chosen distance from the anterior nasal spine, setting projection and rotation without a graft. Photographic and objective analysis covered projection, rotation, shape, deviation, alar width and flare.

Sections of note

• 1,096 consecutive primary endonasal cases, 2005-2025.
• Long-term stability of projection and rotation in 96% at a minimum 12-month follow-up.
• All measured tip parameters improved significantly (p < 0.001).
• Revision rate 3.2%; complication rate under 1%.
• The authors highlight use in mestizo patients, who typically have weak tip support, and applicability to open or closed surgery.

What it means for a patient

• Tip projection can be gained with a suture alone, using the patient's own septum, rather than a cartilage graft.
• In this very large series the result held in 19 of 20 patients and revisions were uncommon.
• The technique depends on a sound, straight septum to anchor to.

Why this paper matters

It is one of the largest single-technique tip series in the literature and supports a graft-free, closed approach in Latin American noses. Limits: retrospective, single group, self-assessed outcomes without a validated patient questionnaire in the abstract.

Terms

• Septocolumellar suture: a stitch joining the medial crura (in the columella) to the front edge of the septum.
• Caudal septum: the front, lower edge of the septal cartilage.
• Anterior nasal spine: the bony point at the base of the septum.
• Mestizo: people of mixed Indigenous American and European ancestry, whose noses often have thick skin and weak tip cartilage.
• Alar flare: outward curve of the nostril walls.