Columellolobular Strut: A Biomechanically Validated Technique for Stable Nasal Tip Support

Introduction Maintaining nasal tip projection and rotation while preserving physiological mobility remains challenging in rhinoplasty. Objectives & Hypotheses This study aimed to evaluate the clinical feasibility and biomechanical behavior of the columellolobular strut. We hypothesized that an angled configuration would demonstrate balanced mechanical behavior under load. Study Design This was a retrospective observational case series (N=115) supported by finite element modeling, conducted in accordance with STROBE guidelines. Methods Patients undergoing primary rhinoplasty between January 2021 and April 2024 were included. Finite element modeling assessed deformation and stress at 120°, 150°, and 180° under standardized compressive loading. Clinical outcomes were evaluated descriptively. Results Stable nasal tip projection and columellar position were clinically observed during a mean follow-up of 32 months. Finite element analysis demonstrated reduced deformation and stress with decreasing angulation, with the 120° configuration showing the most balanced response. Conclusions The columellolobular strut represents a biomechanically supported option for nasal tip stabilization while preserving controlled tip mobility.