Q: For my 4th Revision Asian Rhinoplasty, I want to add columellar strut to support the tip using irradiated rib cartilage. Could it be shaped as if there’s a ‘half bone cut’ look? Could columellar strut be added using ear cartilage by the way? Thank you!
A: A common maneuver to support the tip or push out a retracted columella to improve its appearance is the use of a columellar strut or septal extension graft. It’s not quite clear to me what you mean by “half bone cut” look, but several aspects of the shape, width, projection, rotation of the tip and infratip lobule can be manipulated with a columellar strut/septal extension graft.
Ear cartilage is typically not the best option for use as a columellar strut as the cartilage and softer and more curved than other options (septum or rib). Especially since this is your 4th revision, be sure to complete your due diligence finding a revision rhinoplasty specialist experienced in Asian rhinoplasty.
