Rhinoplasty: Q&A

Ask a Question

Tongue-In-Groove Vs. Cartilaginous Columellar Strut?

Why would you use Tongue-in-Groove vs. Columellar Strut? What is the difference, what outcome, and which technique is better? When and why would you use one technique over the other? Do both techniques produce the same or similar results? Would you do Tonque-In-Groove on someone who had septoplasty 20 years ago? Thanks in advance!

Tags:

Comment on this

13 Doctor Answers | Asked by rena2013 in Chicago, IL

Doctor Answers (13)
Community Comments (0)

Columellar struts are useful for providing tip support during Rhinoplasty Surgery.

In my practice, columellar struts are placed nearly routinely during Rhinoplasty Surgery. Columellar struts typically measure 25mmX4mm, and are placed in a pocket between the medial crurae of your lower lateral cartilages. This added cartilage adds strength and longevity to the position of your tip. A tongue-in-groove technique refers to suture-fixating the medial crurae of your lower lateral cartilages to the bottom of your septum. This technique may be used to lift your tip, rotate... more

Eric M. Joseph, MD

197 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Tongue in Groove and Columellar Strut in Rhinoplasty

Columellar strut can be used for tip stabilization and can be fixed to the anterior nasal spine or left floating sutured to the medial crura. This can help with maintaining projection or improving projection. The tongue in groove involves suture fixation of the hanging columella medial crura to the septum. Kenneth Hughes, MD Los Angeles, CA

Tongue-In-Groove vs Columellar Strut

The main difference lies in fixation of tip cartilages onto the septum in the tongue-in-groove technique, which in theory can provide a better long term support of the tip. However, there are many nuances in making a determination with which technique to proceed. History of previous septoplasty surgery, and the remaining size and shape of septal cartilage, can certainly influence this decision. Both techniques can help with tip rotation and projection, and selection of which technique to use... more

Surgical techique in rhinoplasty is very dependant on the patients anatomy as well as personal preference of the surgeon

Both columellar struts and tongue in groove are ways to support a nasal tip as well as rotate or increase tip projection (how far the tip stands out from the face). I use columellar struts much more often but there are certainly times when i prefer tongue in groove as well. Either may be applicable and really depend on a comprehensive evaluation and treatment plan from a rhinoplasty specialist.

Columellar strut

Columellar struts are occasionally used when patients have very ptotic tips. They are not used in the majority of rhinoplasty surgeries.There are multiple techniques such as tongue in groove and cartilaginous columellar struts. The struts may or may not be sewn to the tip cartilages when necessary.The decision on which technique to use is made at the time of the surgery by your rhinoplasty surgeon. After having had a previous septoplasty, the bigger... more

Tongue in Groove vs. Columellar strut

You have very good questions but I must agree with Dr. Menachof. The decision on what technique to use in order to give you the results that you are looking for should be left up to your surgeon. Do not micro-manage your surgery. Choose your surgeon based on the results and common understanding that you both have in what your goals are and your surgeon's ability to deliver. I think that it is fine to discuss these questions during your consultation after your surgeon has been able to examine... more

Columella struts and tongue in groove

A tongue in groove procedure is when the columella is brought up to the caudal septum and secure. This can be used for hanging columella. A columella strut is used for support.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Tongue-in-Groove Vs. Strut Is Not The Question You Should Be Asking

You have received some very good answers to your question from my colleagues. There are some very good descriptions of the differences between the techniques so I won't add to that. My question to you (without meaning to be harsh) is why do you care? You aren't going to choose a rhinoplasty surgeon because he or she does a great tongue in groove operation. You are choosing him or her (at least I hope you are) because their rhinoplasty results look great. The art of doing a great rhinoplasty... more

Whether to use tongue-in-groove versus columellar strut technique

Hello renap1, The decision on whether to use a tongue-in-groove technique versus a columellar strut is based on the specific situation and anatomy that you have. Both are excellent methods of stabilizing and securing the nasal tip cartilages during rhinoplasty. The tongue in groove technique works well if the caudal septum is already very long (and in the midline). In some people the medial crural cartilage that make of the coluemlla are already overlapping the septum. It also... more

Tongue-in-Groove technique vs. Columellar Strut

Thank you for the question. This is certainly an advance and technical point, and requires a lot of time and detail to explain. In general, each technique is used to stabilize the tip. The tongue-in-groove method, however, can be used to rotate the tip of the nose up. A columellar strut generally does not result in tip rotation, or in some cases, can rotate the tip down slightly. A rhinoplasty expert can meet with you to discuss these and other techniques specifically in reference to... more

Rhinoplasty columellar struts

Your question is quite technical and as you have already had a septoplasty what can be or should be done and how becomes a very open question. Perhaps we should know more about what results you are after.

Rhinoplasty surgery

Dear renap1, It all has to do with your exam and determining what works for the surgeon Both techniques are great to secure the position of the tip Adding a strut may lengthen the septum, and you may need this if it makes the nose look better than tongue in groove which can set the columella back a little bit Best regards, Nima Shemirani

You need to be seen

This can not be answered without an in person examination by an experienced rhinoplastic surgeon. All you should care about is the result not the techniques. We do these closed and do whatever we need to get a pleasing result.