L-shaped columella strut for the Asian tip plasty

Man Koon Suh, M.D.

JW Plastic Surgery Center, Seoul, Korea

Introduction

There are several obstacles in many steps of the Asian tip such as very small alar cartilage,

deformed medial crus and very small septal cartilage.

When we encounter a very small septal cartilage, we may have a difficulty to get optimal

result from columella strut graft, which is very common tip plasty technique.

Therefore, I designed the L-shaped columella strut to solve a problem of very small septal

cartilage.

Materials and Methods:

Harvested septal cartilage is carved into L-shaped, and one limb of L-shaped strut is fixed to the

caudal septum. Dome of both alar cartilages are fixed to the end of the L-shaped columella strut.

In case of very small septal cartilage, L-shaped columella strut is fixed to septal angle.

210 cases of primary and secondary tip plasty were done by this technique.

Results:

Tip projection with this technique was enough and well maintained.

Tip shortening(long nose correction), tip elongation, columella projection and columella retraction

were also be able to achieved.

No specific complications were noted.

Conclusions:

A very small septal cartilage, the most common obstacle of Asian short nose correction, can

be overcome by L-shaped columella strut. Even with a very small septal cartilage, tip

projection could be done effectively. This technique ensures the possibility of columella strut

even in the situations with useless small septal cartilage.

The tip is more soft than the septal extension graft.