The Semi-columellar Strut Technique: Correction of Slight Sagittal Deviation of the Septum

Reinforcement of the nasal tip is a key step in modern rhinoplasty, typically achieved using techniques such as tongue-in-groove, septal extension grafts, or columellar struts. We present a novel method, the semi-columellar strut, designed for patients with mild sagittal septal deviation and a properly aligned caudal septum. This technique involves a partial incision of the caudal septum to increase flexibility, suturing of the alar domes, and fixation of the medial crura to the septum, followed by a tip rotation control suture securing the upper medial crura to the nasal dorsum. The semi-columellar strut provides effective tip reinforcement while maintaining independent tip projection, can be completed in 3-5 minutes, and avoids the complexity and operative time associated with traditional septal reconstruction procedures. Based on our clinical experience of 58 patients, the technique yields consistently satisfying aesthetic outcomes in appropriately selected cases. While it does not correct internal septal deviation or improve nasal airflow, it achieves reliable aesthetic outcomes in selected cases, offering a simple, efficient alternative for nasal tip stabilization in rhinoplasty.