Long-Term Durability of Tip Projection and Rotation with Strut Columella and Septal Extension Graft in Rhinoplasty: A 6-Month and 1-Year Follow-Up

Vaghardoost R, Zahedi A, Abbaszadeh A.

PubMed 41629470 Publisher (DOI)Free full text (PMC)

What this paper says

Comparing columellar strut and septal extension grafts over a year, tip projection was equal at 6 months but differed significantly at 12 months, which the authors interpret as the extension graft holding projection longer.

Overview

Tip projection and rotation are central to how a nose looks, and the two main support techniques are the columellar strut and the septal extension graft (SEG). Patients were divided into two groups; angles and distances were measured with digital photo software before surgery, immediately after, and at 6 and 12 months, and satisfaction was recorded with the ROE questionnaire. Patient numbers are not given in the abstract.

Sections of note

Rotation: no preoperative difference; a significant difference immediately after surgery; no difference at 6 or 12 months.
Projection: no difference before surgery, immediately after, or at 6 months; a significant difference at 12 months.
The authors conclude the SEG "has greater durability than columellar strut" over the long term.
The journal assigned Level of Evidence I, though the abstract does not describe randomisation or blinding.

What it means for a patient

Both grafts held rotation equally well at a year.
Projection diverged only at 12 months, suggesting some late settling with the strut in this study.
The abstract lacks group sizes and actual measurements, so the size of the difference is unknown.

Why this paper matters

It adds to a contested question about which tip-support graft lasts longer. Limits: no patient numbers, no effect sizes, and no direction of difference stated in the abstract; the Level I rating should be read with caution.

Terms

Columellar strut: a cartilage post between the tip cartilages, floating rather than fixed to the septum.
Septal extension graft (SEG): cartilage fixed to the septum that the tip is sutured to, giving rigid control.
Tip projection: forward distance of the tip from the face.
Tip rotation: the up-or-down tilt of the tip.
ROE: Rhinoplasty Outcome Evaluation questionnaire.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

Abstract

Introduction: The two main features that are important in defining the attractiveness of the nose include the projection and rotation of the tip of the nose. Among many techniques, Strat and SEG are much more efficient. The purpose of this study is to compare these two methods in preserving and maintaining of the tip of the nose.

Research Method: This study was conducted in two groups. Before, immediately after the operation and at intervals of six months and one year, distances and angles were measured with digital photo viewer software. Additionally, their satisfaction with the results of the operation was recorded on the basis of the prepared ROE questionnaire. Finally, the data were recorded in an Excel file and analyzed with statistical analysis software.

Findings: There was no significant difference in rotation before surgery between the two groups, but there was a significant difference in average rotation immediately after surgery. In addition, there was no significant difference between the averages at six months and 12 months after surgery. On the other hand, the preoperative projection did not significantly differ between the two groups. In addition, the mean projection immediately after surgery and six months later did not significantly differ between the two groups, but a significant difference was observed 12 months later.

Conclusion: Therefore, the SEG method has greater durability than columellar strut does in the long term and can maintain the shape of the nose for a longer period.

Level Of Evidence I: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Abstract as indexed by PubMed; the article is open access (PubMed Central).