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The Effect of Anchoring the Columellar Strut Graft to the Lateral Crural Steal Suture in Patients With a Low Nasal Tip: A New Technique

Objective: The achievement of consistently superior results in rhinoplasty is difficult. This study aimed to evaluate the effect of anchoring the columellar strut graft to the thread of the lateral crural steal for nasal tip projection and rotation. Study Design: A retrospective, case-control study. Methods: Two groups were created which consisted of patients who had a history of low nasal tip deformity according to the type of nasal tip surgery in rhinoplasty. In group 1, the lateral crural steal technique with the strut graft was used, whereas in group 2, a new technique, in which the strut graft was anchored to the thread of the lateral crural steal, was used. Patients with low nasal tip deformity due to intrinsic factors such as long lateral crura were included. The effects of the 2 different surgical approaches on facial parameters (the nasolabial angle, nasofacial angle, and Goode ratio) were statistically compared using the Mann–Whitney U test and Student t test, as applicable. Results: Sixty patients were enrolled: half of them were included in group 1 and the other half in group 2. Average postoperative increases of the nasolabial angle score were 10.9 ± 4.72° and 18.76 ± 6.30° in groups 1 and 2, respectively (P < 0.001). Average improvements of the nasofacial angle were 2.33 ± 2.12° and 3.50 ± 2.44° in groups 1 and 2, respectively (P = 0.053). Average postoperative increases of the Goode ratio were 0.02 ± 0.02 in group 1 and 0.04 ± 0.03 in group 2 (P = 0.028). Conclusion: The new technique provided a prominent nasal cephalic rotation with a strong effect on the nasolabial angle and a partial effect on nasal projection.