Measured Gain in Projection With the Extended Columellar Strut-Tip Graft in Endonasal Rhinoplasty

Importance: The extended columellar strut-tip graft was designed to improve nasal tip projection and tip definition in patients undergoing rhinoplasty. Objective: To determine whether the extended columellar tip graft leads to a true and measurable increase in nasal tip projection or simply gives the illusion of an increase in projection. Design: Retrospective case review. The mean time of follow-up photographs was 32 months after surgery (range, 8 months to 10 years). Participants: The study population comprised 15 patients who underwent primary or revision rhinoplasty during the last 10 years. Intervention: Primary or revision rhinoplasty. Main Outcome Measure: The outcome measure was the long-term gain in nasal tip projection. Preoperative and postoperative images were cropped and sized equally for accurate comparison. All measurements were made from the alar-facial crease to the tip defining point. Results: In all 15 patients, an increase in tip projection was obtained. The mean increase in projection was 19% compared with the preoperative projection. After applying a paired t test for analysis, there was a statistically significant increase in nasal projection (P < .05). Conclusions and Relevance: The extended columellar strut-tip graft effectively corrected poor nasal tip projection. The effect is maintained years later. The extended columellar strut-tip graft is an excellent choice in endonasal rhinoplasty to improve poor tip projection and definition.