| Effects The columella strut produces a number of favorable ef fects (Figure 1).
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Figure 1. The Columella Strut |
It will change the nasolabial angle from an acute or right angle to a more favorable obtuse angle. It thus produces an apparent nasal shortening, often reducing the need to shorten the nasal septum. It can support or project tip position as well as rotate the lobule in a cephalic direction. In doing this it not only maintains the desired tip position but helps accentuate the tip. Tip rotation and accentuation over the dorsal profile line results in an esthetically pleasing effect.
The short columella is usually the result of short or weak medial crura. The resulting swelling occurring from the injection of local anesthetic plus surgical trauma will pro-duce an apparent surgical elongation of the columella which will change significantly in the postoperative period leading to a reduction in tip projection and thus altering the final profile result. It is a frequent contributing factor in producing the unfavorable postoperative "polly beak" deformity. The strut will lend support to the medial crura and then maintain columella length or even elongate the short columella.
A retracted or even a straight columella can be changed to the more pleasant convex shape by insertion of the columella strut. This will also generally hide any columella irregularities and can straighten an angulated columella.
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Aesthetics and Aging A New Paradigm
