Tip augmentation in Orientals cannot be obtained sufficiently only by the rearrangement of alar cartilage or onlay cartilage graft because the medial crura are not strong enough to support the tip projection. Thus, tip projection by suture fixation of columellar strut to medial crus is frequently used. In this case, septal cartilage is the first choice for autogenous tissue. However, septal cartilage of Orientals, who has flat nose, is not proper for use, due to its underdevelopment and thinness, so ear conchal cartilage is used instead.
  The authors measured the tip height and naso-labial angle of 10 patients who had tip augmentation by columellar strut using conchal cartilage and have followed up on long term (average 22 months), with preoperative, postoperative & long-term follow-up photographs. The height shows no difference between postoperative and long term follow up. Naso-labial angles lowered 5.1°, but all the patients expressed satisfaction. Donor site and transcolumellar scar were acceptable and there were no distortion or malposition of columellar strut.
  Therefore, the authors concluded that if septal cartilage is not sufficient for use, conchal cartilage can be a good alternative donor site for columellar strut.