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A quantitative appraisal of change in nasal tip projection after open rhinoplasty.

Exact knowledge about the magnitude of the factors influencing nasal tip projection (NTP) as a result of surgery are scarce. This study focuses on NTP changes after primary rhinoplasty using open transcolumellar approach in combination with a columellar strut, while specifically addressing four different nasal tip surgery techniques. Measurements were taken from standardised pre- and post-operative profile photographs of 73 patients with a minimal follow-up of one year. No statistically significant differences in pre- and post-operative NTP could be noted for the total group of patients. Only the group of patients in whom a nasal tip graft was applied a mean increase in NTP could be measured. A comparison of selected data from our study to data of previous studies on NTP changes after endonasal rhinoplasty demonstrates the effectiveness of the columellar strut for maintenance of NTP. Overall, our findings testify to the versatility of cartilage-structuring techniques including columellar struts and tip grafts for NTP maintenance or increase. The quantitative effect of the open approach itself on NTP remains elusive and needs further study.