Extended columellar struts are used when the nasal septum is deficient or absent. Extended columellar struts can be used to signficantly project the nose. The main disadvantage of this graft is the size of it. This graft is typically wide, and will make the columella very wide on frontal and base view. It can make the nose feel too stiff as well. It is typically made from costal cartilage, although thinner extended columellar struts can be made from septal cartilage. It is often connected to a dorsal graft to help recontruct the nasal dorsum.
Extended columellar struts must be distinguished from columellar struts.
“The nose should fit the face”
A strong jawline would suggest a stronger nose.