Silastic alar-columellar prosthesis in conjunction with rhinoplasty.

A Silastic alar-columellar prosthesis, designed by Lawrence Birnbaum, MD, is commercially available. Used as an implant in the columella and overlying the domes and lateral crura of the alar cartilages, it can aid in obtaining and maintaining tip projection and in reshaping the lobule. Its use is limited and should be reserved only for special cases, ie, those patients in whom there is substantial loss of nasal tip projection, or notable asymmetry, or absent alar cartilages and in patients in whom there is a lack of autogenous grafting material. I have used this prosthesis in 19 patients and have found it to be a valuable adjunct.