Measured gain in projection with the extended columellar strut-tip graft in endonasal rhinoplasty.

IMPORTANCE The extended columellar strut-tip graft was designed to improve nasal tip projection and tip definition in patients undergoing rhinoplasty. OBJECTIVE To determine whether the extended columellar tip graft leads to a true and measurable increase in nasal tip projection or simply gives the illusion of an increase in projection. DESIGN Retrospective case review. The mean time of follow-up photographs was 32 months after surgery (range, 8 months to 10 years). PARTICIPANTS The study population comprised 15 patients who underwent primary or revision rhinoplasty during the last 10 years. INTERVENTION Primary or revision rhinoplasty. MAIN OUTCOME MEASURE The outcome measure was the long-term gain in nasal tip projection. Preoperative and postoperative images were cropped and sized equally for accurate comparison. All measurements were made from the alar-facial crease to the tip defining point. RESULTS In all 15 patients, an increase in tip projection was obtained. The mean increase in projection was 19% compared with the preoperative projection. After applying a paired t test for analysis, there was a statistically significant increase in nasal projection (P < .05). CONCLUSIONS AND RELEVANCE The extended columellar strut-tip graft effectively corrected poor nasal tip projection. The effect is maintained years later. The extended columellar strut-tip graft is an excellent choice in endonasal rhinoplasty to improve poor tip projection and definition. LEVEL OF EVIDENCE 4.