Long-term Study Highlights Use of Columellar Struts in Rhinoplasty

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After studying more than 20 years worth of rhinoplasty cases, Dr. Rohrich calls for new emphasis on columellar struts.

Rod Rohrich secondary rhinoplasty

Proper use of columellar struts can help give the nose a softer and more natural appearance.

Compared to other variables that affect tip symmetry, the columellar strut has a unifying quality that renders it unique.

The use of columellar struts in nose modification procedures is more helpful than plastic surgeons might think, according to a study in Plastic and Reconstructive Surgery, the professional journal of the American Society of Plastic Surgeons.

The retrospective analysis of rhinoplasties performed from 1986 to 2009 by Dr. Rod Rohrich, chair of Plastic Surgery at UT Southwestern Medical Center, shows that columellar struts help improve symmetry and projection of the nose to create a softer and more natural appearance for rhinoplasty patients.

The columella is a long, thin segment of cartilage that runs vertically through the nose. Other structures of the nose are either attached to the columella or supported by it.

A strut is a graft typically taken from the septum, which separates the right and left nostril. The strut can significantly project the nose and support the nasal tip. A columella that is retracted or shows too much creates a displeasing aesthetic look on the lower third of the nose.

“Past articles have referred to the use of the columellar strut in rhinoplasty, but its role seems to have been underestimated,” says Dr. Rohrich, the study's senior author. “Compared to other variables that affect tip symmetry, the columellar strut has a unifying quality that renders it unique. Essentially, the strut provides a scaffold on which any tip correction can be used.”

The analysis also classifies what type of columellar strut to use, based on over 20 years of experience and more than 1,700 cases.

The full article is available on the journal’s website.

About Rod J. Rohrich, M.D., F.A.C.S.

Dr. Rod J. Rohrich is a plastic surgeon in Dallas, Texas. Holds the Betty and Warren Woodward Chair in Plastic and Reconstructive Surgery at UT Southwestern Medical Center in Dallas, Texas. He also holds the UT Southwestern Medical Center Crystal Charity Ball Distinguished Chair in Plastic Surgery. A graduate of the Baylor College of Medicine with high honors, he completed residencies at the University of Michigan Medical Center and fellowships at Massachusetts General Hospital/Harvard (hand/microsurgery) and Oxford University (pediatric plastic surgery). Dr. Rohrich has served as president of the American Society of Plastic Surgeons and repeatedly has been selected by his peers as one of America's best doctors. Twice he has received one of his profession's highest honors, the Plastic Surgery Educational Foundation Distinguished Service Award, which recognizes his contributions to education in his field. Dr. Rohrich participates in and has led numerous associations and councils for the advancement of plastic and reconstructive surgery. A native of North Dakota, he is married to Dr. Diane Gibby, also a plastic surgeon. They live in Texas with their two children.

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Rod J. Rohrich, M.D.

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