Columella Reconstruction Using the Philtral Flap in Patients With Columellar Deformity in Revision Rhinoplasty Publisher



Bastaninejad S ; Kanani B ; Ferreira MG ; Amali A ; Sanaye Pasand Z
Source: Aesthetic Plastic Surgery Published:2026

Abstract

Background: Columellar defects, resulting from trauma or surgery, pose both functional and aesthetic challenges. This study evaluates the functional and aesthetic outcomes of columellar reconstruction using the philtral flap method in a case series of fourteen patients with columellar defects, focusing on respiratory and aesthetic outcomes. Methods: Participants: Fourteen patients with columellar defects. Procedure: Costal cartilage was harvested, and a philtral flap was designed with an open approach. Septal and nasal floor mucosae were elevated bilaterally, and a vertical incision was made on the philtrum. A full-thickness flap, including orbicularis oris muscle, was mobilized, and the nasal framework reconstructed with rib cartilage. Evaluations: The SCHNOS questionnaire assessed functional outcomes, while photographic analysis evaluated aesthetic changes. Data were analyzed using SPSS version 24. Results: Functional Outcome: Significant improvement in the respiratory index (p <.001). Aesthetic Outcome: Significant improvement in the nasal aesthetic index (p < 0.001). Photographic Analysis: Significant changes in philtral and columellar lengths, show, and Goode’s ratio. Conclusion: The philtral flap method provides promising functional and aesthetic outcomes, with further studies needed to confirm these findings. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. © Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2026.