Columella Flap: A New Approach for Columella Reconstruction.

BACKGROUND

The columella is a complex structure comprised of skin, subcutaneous tissue, and cartilage. A columella that is deformed or defective requires surgical intervention. The authors developed a local flap to treat nasal columella defects based on lip lifting markings.

OBJECTIVES

The aim of this study was to evaluate the efficacy of the newly developed columella flap technique for reconstructing nasal columella defects and short columellas by assessing aesthetic and functional outcomes, and determining the complication rates associated with this innovative approach.

METHODS

A retrospective analysis of medical records was performed for patients who underwent columella reconstruction using a flap developed by the authors. Each patient received outpatient follow-up for a minimum of 1 year after surgical intervention, from October 2023 to December 2025. Patients completed a questionnaire to assess how they perceive their nose before and after rhinoplasty, including expectations, aesthetic satisfaction, and the impact on their social and professional life, in order to evaluate aesthetic and surgical outcomes and overall satisfaction. The same questionnaire was provided again 1 year after the procedure. Patient satisfaction was assessed by comparing the responses from both time points.

RESULTS

Twenty patients underwent the procedure. The proposed flap significantly improved columella reconstruction, with the majority of patients reporting aesthetic and functional benefits. Only a few minor and common complications were observed.

CONCLUSIONS

The columella flap is a versatile tool used to reconstruct these deformities. The use of this new flap can help correct most columella deformities, bring functionality and is aesthetically acceptable, with minor complications.

LEVEL OF EVIDENCE: 4 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.