Alternative Technique for Tip

Background: Re-establishing nasal tip projection is one of the main objectives in secondary rhinoplasty. The columellar strut is used as a basic element for support and the septal cartilage graft as the first choice for reconstruction. Nevertheless, the sep-tal cartilage is often missing in this category of patient because of previous surgery, obliging the surgeon to seek a safe, effec-tive, and versatile alternative. Objective: We describe a simple procedure to increase the strength of an autologous ear graft cartilage to be used as a col-umellar strut in patients having secondary rhinoplasty. Methods: We removed a 3.5 1.5-cm auricular concha graft through a postauricular approach, leaving the perichondrium on the posterior surface and trimming it on the helical crus. Later, we made a cylinder-shaped structure to be used as a columellar strut graft in patients in whom the septum was absent. We used the open rhinoplasty technique, applying the basic principles of secondary rhinoplasty, in all of the patients. Results: Between February 2002 and June 2006, we used this technique in 13 patients ranging in age from 19 to 52 years who required revision rhinoplasty. The clinical follow-up period ranged from 4 to 48 months. Five of the patients experienced minor complications; nevertheless, all were satisfied with the postoperative results. Conclusion: The auricular cartilage struts constructed using this method were strong enough to enhance tip support and pro-jection, with satisfactory results assessed by both the patients and our team. (Aesthetic Surg J 2006;26:662–668.