Journal archive · Rib, ear and septal grafts · Nasal tip · Open versus closed approach · 2015
Reply: Revisiting the Role of Columellar Strut Graft in Primary Open Approach Rhinoplasty
Bitik O.
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Rib, ear and septal grafts
Modern rhinoplasty builds rather than removes, so the operation runs on cartilage: the septum first, then the ear, then the rib, and when none of those will do, a piece of donated rib from a tissue bank.
Nasal tip
Tip surgery is now a support problem rather than a sculpting problem: the septal extension graft holds projection and rotation where the columellar strut loses them (0.2% against 4.7% projection loss at one year), and the current series repair, reposition and reinforce the lower lateral cartilages instead of excising them.
Open versus closed approach
Whether the surgeon opens the nose through a small incision across the columella or works entirely through the nostrils has been argued in print since 1973, was put on facing pages of Plastic and Reconstructive Surgery by Jack Gunter and Jack Sheen in 1997, and was finally pooled in 2025: across twenty studies and 1,067 patients there is no significant difference in what patients report, in breathing, in complications or in swelling.
Related papers
Same topic, 2015.
- ASJ Comments on "The Lateral Crural Rein Flap: A Novel Technique for Management of Tip Rotation in Primary Rhinoplasty"Ozucer B, Ozturan O2015PMID 26116747
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- ASJ External rhinoplasty by skin excision to correct hypertrophic tip of an elderly patientBertrand B, Georgiou C, Degardin N et al.2015PMID 26508652Full text
- ASJ Response to "Comments on 'The Lateral Crural Rein Flap: A Novel Technique for Management of Tip Rotation in Primary Rhinoplasty'"Kuran İ, Öreroğlu AR, Efendioğlu K2015PMID 26116748
- APS Alar-columellar and lateral nostril changes following tongue-in-groove rhinoplastyShah A, Pfaff M, Kinsman G et al.2015PMID 25673570Summary
- APS Tongue-in-Groove Setback of the Medial Crura to Control Nasal Tip Deprojection in Open RhinoplastyDatema FR, Lohuis PJ2015PMID 25491013Summary
- AJRA Nasal tip sutures: Techniques and indicationsCingi C, Muluk NB, Ulusoy S et al.2015PMID 26637571Abstract
- FPS Clin Lateral crural repositioning for treatment of cephalic malpositionToriumi DM, Asher SA2015PMID 25430928Abstract