Q: Dr. Eppley, I have an ethnic rhinoplasty question. Is there a medical term for putting a building block or supporting structure under the nose tip if you don’t have much under there? (i.e such as that in Asian and African American noses) I thought it was a nasal strut but I don’t think that is it because that is only used when someone’s nose tip is drooping. Would a nasal strut make someone’s nose more turned up than it already is? Mine is already turned up. I am just asking because I am trying to figure out exactly what I need before I do anything. Thanks.
A: Your question appears to relate specifically to ethnic rhinoplasty. What you refer to as a nasal strut is more specifically called a columellar strut. This is a vertical strut of cartilage placed between the base of the nose up to the tip between the medial footplates of the lower alar cartilages. This is a very versatile support graft that can be used for a variety of nasal reshaping. purposes such as long-term support to prevent tip collapse/rounding to being long enough to increase actual nasal tip projection.
The use of a columellar strut is of critical importance in just about every Asian and African-American ethic rhinoplasty to change the rounded tip of the nose to a more narrow one with better definition. It is not the only rhinoplasty maneuver done to create that effect but it would be considered the ‘building block’ of the tip of the nose. A columellar strut, in and of itself, will not necessarily increase nasal tip projection. When combined with a variety of other cartilage grafts (e.g., septal extension graft) it may even be used to decrease tip projection while also making the nasal tip less wide and more defined.
Dr. Barry Eppley