Whats the Difference Between a Columellar Strut and Nasal Spine Augmentation? (photo)

The two do different things but are related

the "spine augmentation " would essentially be a graft located where your upper lip meets the base of your nose at the columella centrally.  It would make the nasolabial angle less acute and decrease your overly sloped upper lip.

the columellar strut would help with that a little but would be more directed at tip support (increased tip projection) and and increasing columellar show to a natural / normal level

if you were to come see me I might suggest both but I think I would stress the columellar strut as the more important of the two .

other issues need to be addressed two in order to get you close to the simulated post op photo.

Nasal spine augmentation and a premaxillary implant are basically the same type of implants, usually harvested from either autologous substances (bone or cartilage) or synthetic material (silastic or Gortex).  Both of these bring the entire base of the nose forward at the nasal spine area.  The pictures that are shown display unrealistic expectations.  There is too much augmentation of the nasal spine and bridge that is physically possible to do at the time of the rhinoplasty surgery.

What you are after to achieve your imaged results is tip lengthening with the aid of a columellar strut and tip grafting. Nasal spine augmentation will not increase tip projection but opens up the nasolabial angle which has the benefit of improving a more flattened facial profile.