Role of columellar strut in long-term maintenance of tip support in primary Rhinoplasty

Background: The nasal tip can be enhanced or improved using several different procedures. To get the intended outcome, these procedures frequently make use of undetectable grafts and stitching methods. The literature provides a thorough description of the earlier techniques. Among these later methods, the columellar strut continues to be a widely used and successful type of invisible graft in rhinoplasty. The goal of this research is to clarify whether or not the columellar strut graft is a necessary step in maintaining tip support during a primary rhinoplasty. Aim: Debatable has been the impact of a columellar strut graft on the ultimate location of the nasal tip. The objective of this research was to conduct a prospective analysis of thirty consecutive primary rhinoplasty instances, both with and without the use of columellar strut grafts. The study specifically aimed to compare the changes in nasal tip position that occurred before and after surgery. Patients and Methods: The Plastic, Burn, and Maxillofacial Surgery Department at Ain Shams University Hospital carried out this 2-year, two-arm, randomized control clinical study between 2020 and 2022. There were two groups: the first had a rhinoplasty with a columellar strut, while the second group had surgery without a strut graft. Results: The examination of the changes in nasal tip rotation and projection was the primary focus of postoperative assessment. This was achieved by measuring and comparing the nasolabial angle and Goode ratio (preoperative and 6 months postoperative). With the columellar strut group, we saw a considerable improvement in tip rotation and projection postoperatively, which was in line with the patient's satisfaction with the ultimate cosmetic results. Conclusion: This study shows that, when compared with preoperative measurements, postoperative nasal projection and the nasolabial angle (NLA) are raised and stabilized. This implies that the columellar strut graft is a useful tool for supporting the nasal tip and improving the success of rhinoplasty.