Journal archive · Rib, ear and septal grafts · Nasal tip · Septum, valve and airway · 2025
Optimizing Nasal Tip Position: A Systematic Review of Columellar Strut and Septal Extension Grafts
Amador RO, Hamaguchi R, Bartlett RA, Austen WG Jr.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on columellar strut.
From the abstract
“Nasal tip position is a crucial aspect of rhinoplasty. To stabilize and define the nasal tip, various cartilaginous grafts have been widely utilized. The purpose of this systematic review is to critically evaluate and compare 2 prevalent grafting techniques: columellar strut grafts (CSGs) and septal extension grafts…”
Excerpt; the full abstract is on PubMed.
Citation
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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.
Septum, valve and airway
Every rhinoplasty is a breathing operation whether it intends to be or not: the septum holds the nose up as well as dividing it, and the narrowest part of the whole airway is the internal valve the surgeon is standing over.
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