Columellar struts are used to help support the nasal tip. Their use in rhinoplasty is for patients where projection is to be maintained or slightly projected.
Columellar struts can be used with either an endonasal approach or external approach. The main disadvantage of columellar strut is that the graft floats and is not attached to the septum. This means that nasal tip position is less predictable with this graft as opposed to a caudal extension graft.