Lateral Crural Steal With Columellar Strut Graft in Primary Open Rhinoplasty

Inclusion Criteria: * Patients seeking primary rhinoplasty for aesthetic and/or functional indications. * Presence of inadequate nasal tip projection and/or rotation suitable for correction using lateral crural steal with columellar strut graft. * Ability to provide written informed consent and comply with follow-up visits. Exclusion Criteria: * History of prior nasal surgery. * History of severe nasal trauma, altering cartilage architecture. * Significant functional nasal obstruction requiring complex external nasal valve reconstruction. * Patients with excessively wide alar base requiring alar base reduction involving vestibular sill excision (to prevent confounding on projection/rotation). * Patients with facial skeletal or developmental abnormalities e.g. maxillary hypoplasia, maxillary prognathism, dentofacial deformities. * Patients with psychiatric illness or Body Dysmorphic Disorder. * Significant medical comorbidities contraindicating elective surgery or general anesthesia. * Inability to provide informed consent or comply with follow-up.