Columellar Strut - When is It Necessary?

I recently underwent rhinoplasty (a few months ago) and my doctor did not put in a columellar strut. During the initial consultation, I had mentioned to her that another plastic surgeon had recommended a strut (I didn't use that doctor because he was too expensive) but she insisted that I don't "need" it. Now I am noticing that my tip came down a bit...is it because a strut was not inserted?

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11 Doctor Answers | Asked by Forest Hills in Forest Hills, NY

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Columella-struts may be used during Rhinoplasty Surgery to support your tip.

During most rhinoplasty surgeries, I will harvest, sculpt and place a columella-strut. These cartilage grafts measure 3-4mm (width)X20-25mm (length), and are sutured in between your tip cartilages. Columella-struts add tip support, maintain tip orientation, and lead to a more durable nasal tip. Most nasal tips "come down a bit" during the early post-operative course. If you're concerned by the appearance of your nose, you should consult your surgeon. I hope this is... more

Eric M. Joseph, MD

199 reviews

West Orange Facial Plastic Surgeon

www.ericmjoseph.com

When should a columellar strut graft be used?

As a facial plastic surgeon, I perform my septorhinoplasty by the open approach. I usually harvest a strut graft from the septoplasty portion of the procedure. I prefer using the patient's cartilage rather than an alloplastic material. Depending on the approach (open vs endonasal), once postoperative swelling resolves, your tip might drop slightly. Other maneuvers such as dome suturing can narrow and project the tip and if these were not performed, your tip may appear like... more

Maintaining nasal tip position

A columellar strut is just one method of maintaining or increasing nasal tip projection. Other techniques such as tip grafting and various suture techniques are also effective, and each surgeon has his or her favorite methods. Following rhinoplasty, the nasal tip almost always drops a bit no matter what technique is used. The question is, do you feel that your tip is now too low? If so, discuss this with your surgeon.

Columellar strut

The columellar strut is a small cartilaginous graft harvested from the inside of the nose and is used to prop up a very droopy nasal tip. It is one small technique in a variety of procedures to try and bolster nasal tip projection and prevent sagging. Not all surgeons will agree on a given nose as to whether or not a columellar strut needs to be placed. Columellar strut does tend to make the tip quite stiff after the surgery. The relaxing of the tip in the downward position varies with... more

Columellar Struts

Columellar struts are grafts placed betwen the cartilages of the columella to provide tip support or increase tip projection. Without examining you or seeing pictures it is impossible to determine if a strut would have made any difference - there are many different techniques used in rhinoplasty surgery. If necessary, a strut can be added at a later date.

Richard W. Fleming, MD

9 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

When to use a columellar strut in rhinoplasty

Like with so many things in life, the answer is, "it depends." Tip drop after rhinoplasty can occur with or without the use of a strut graft so using one is no guarantee of a good outcome and struts can have their share of complications, too (over-projection, warping, clicking, widening of the columella, etc.). I don't always use them if I'm stabilizing the tip in other ways, but I do make sure to stabilize the tip one way or another. I usually recommend that patients... more

When SHOULD a (columellar) Strut Graft be used in Nose Surgery?

Regarding: "Columellar Strut - When is It Necessary? I recently underwent rhinoplasty (a few months ago) and my doctor did not put in a columellar strut. During the initial consultation, I had mentioned to her that another plastic surgeon had recommended a strut (I didn't use that doctor because he was too expensive) but she insisted that I don't "need" it. Now I am noticing that my tip came down a bit...is it because a strut was not inserted?" In general, a more

Columellar Strut Graft for Rhinoplasty

Hi Forest Hills in Forest Hills, NY, A columellar strut is a cartilage graft that is placed at the base of the nose, in between your natural lower nasal cartilage. The columellar strut can help keep the nose straight, project the tip, and stabilize the tip. Columellar strut is a more common cartilage graft as compared to the many other rhinoplasty grafts available. Rhinoplasty is not one operation, but rather many potential operations. Each plastic surgeon may have different... more

Columella struts

I do not always use a strut. When I first started doing rhinoplasty ( open) i used them all the time. I found it was not necessary in most cases. In fact, I found that the strut sometimes widened the columella too much for my taste. The tip dropping may or may not be related to the columella strut not being used.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Collumellar strut rhinoplasty can help with tip projection.

Hi. This is the kind of thing that requires detailed physical examination. But, as a generalization, when tip projection is questionable, we use collumellar struts.