The Effect of Septal-Columellar Strut Stabilizer Suture on Nasal Tip Projection and Rotation

Objective: In rhinoplasty, ensuring and maintaining stability of the nasal tip is one of the challenging factors. We describe the septal-columellar strut stabilizer suture (SCSSS) technique and evaluate its efficacy in preserving nasal tip rotation and projection.Material and Methods: A retrospective cohort study was conducted on 62 primary open rhinoplasty patients between January 2020 and January 2025. Patients were divided into two groups: the study group (n = 36), where the SCSSS technique was employed, and the control group (n = 26), where it was not. Nasal tip projection and rotation were objectively measured using ImageJ software on preoperative, postoperative 1-month, and 12-month profile photographs. Goode ratio was used to measure nasal tip projection, and the Nasolabial Angle (NLA) was used to measure nasal tip rotation.Results: Preoperative measurements were similar in both groups (p > 0.05). At the 12-month follow-up, the study group demonstrated significantly higher NLA values (100.50± 6.25) than the control group (95.85±5.64) (p = 0.004). The mean loss of rotation between postoperative 1 and 12 months was significantly lower in the study group (2.57±2.30 vs. 10.01±4.39; p<0.001). Regarding projection, the study group maintained significantly higher Goode ratios at 12-month (0.64±0.05 vs. 0.60±0.05; p=0.004), although the rate of projection loss over time was similar between groups (p = 0.483).Conclusion: The SCSSS technique is an effective and easily applicable method for stabilizing the nasal tip. It significantly improves the long-term stability of nasal tip rotation and aids in maintaining nasal tip projection.