Septocolumellar strut technique: Tip stability and aesthetic outcomes in rhinoplasty

Abstract

Background The septocolumellar strut (SCS) technique has been proposed as an additional support element to enhance tip stability when used alongside a traditional columellar strut in open rhinoplasty. Evidence on its early and long-term effects remains limited. Methods A retrospective analysis was conducted on 40 patients (mean age 34.1 years; 80% female) who underwent open rhinoplasty with combined SCS and columellar strut placement. Outcomes assessed at postoperative 3 and 12 months included Goode\"s ratio, nasal length, tip rotation (nasolabial angle), and tip projection. Results Significant improvements were observed at both 3 and 12 months in Goode\"s ratio (0.59 -> 0.61 -> 0.61, p 54.0 -> 53.5 mm, p 98.5 degrees -> 96.0 degrees, p < 0.001). Tip projection remained stable throughout follow-up. From month 3 to month 12, percent change was 0.0% for Goode\"s ratio, 0.0% for nasal length, -1.8% for tip rotation, and 0.0% for tip projection. No significant differences were detected between 3rd- and 12th-month values except for a minor decrease in tip rotation (p < 0.001). Conclusions The combined SCS-columellar strut technique yields durable aesthetic and structural outcomes in open rhinoplasty. Gains in Goode\"s ratio, nasal length, and tip rotation are well maintained over 12 months, with tip projection remaining preserved. (c) 2026 The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)