TY - JOUR
T1 - The dorsal columellar strut
T2 - Innovative use of dorsal hump removal for a columellar strut
AU - Rohrich, Rod J.
AU - Liu, Jerome H.
PY - 2010/2
Y1 - 2010/2
N2 - Background: Dorsal hump reduction is a common complaint among primary cosmetic rhinoplasty patients. Newer techniques for addressing the dorsal hump focus on the preservation, reinforcement, or modification of existing structures. Objectives: The authors describe their technique of a "dorsal columellar strut," an innovative use of dorsal nasal cartilage from hump removal for a columellar strut. Combined with other cartilage-conserving techniques, this forgoes the morbidity and operative time of a septal cartilage harvest while preserving-and possibly increasing-tip support. Methods: Candidates for this procedure are selected based on a number of criteria. Ideally, the patient is one who requires 3 mm or more of dorsal hump reduction with tip reshaping and refinement. Each patient is treated using the open technique with a stair-step columellar incision, combined with an infracartilaginous incision. Results: With the addition of the authors cartilage-conserving techniques (autospreader flap, lower lateral turnover, and tip suturing), patients experience successful reshaping of the middle vault and nasal tip. Conclusions: In well-selected patients, the authors have found their technique to be efficient, effective, and aesthetic. The precise dorsal reduction allows surgeons to use the cartilage fragment as a dorsal columellar strut, foregoing the standard septal harvest and reducing operative time and patient morbidity.
AB - Background: Dorsal hump reduction is a common complaint among primary cosmetic rhinoplasty patients. Newer techniques for addressing the dorsal hump focus on the preservation, reinforcement, or modification of existing structures. Objectives: The authors describe their technique of a "dorsal columellar strut," an innovative use of dorsal nasal cartilage from hump removal for a columellar strut. Combined with other cartilage-conserving techniques, this forgoes the morbidity and operative time of a septal cartilage harvest while preserving-and possibly increasing-tip support. Methods: Candidates for this procedure are selected based on a number of criteria. Ideally, the patient is one who requires 3 mm or more of dorsal hump reduction with tip reshaping and refinement. Each patient is treated using the open technique with a stair-step columellar incision, combined with an infracartilaginous incision. Results: With the addition of the authors cartilage-conserving techniques (autospreader flap, lower lateral turnover, and tip suturing), patients experience successful reshaping of the middle vault and nasal tip. Conclusions: In well-selected patients, the authors have found their technique to be efficient, effective, and aesthetic. The precise dorsal reduction allows surgeons to use the cartilage fragment as a dorsal columellar strut, foregoing the standard septal harvest and reducing operative time and patient morbidity.
KW - columellar strut
KW - component dorsal reduction
KW - dorsal hump
KW - dorsal hump reduction
KW - hump reduction
KW - rhinoplasty
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U2 - 10.1177/1090820X10362731
DO - 10.1177/1090820X10362731
M3 - Article
C2 - 20442071
AN - SCOPUS:77954065227
SN - 1090-820X
VL - 30
SP - 30
EP - 35
JO - Aesthetic surgery journal
JF - Aesthetic surgery journal
IS - 1
ER -