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Can Lateral Crural & Columellar Struts Ever Be Removed?

asked 6 months ago by Marie79
Latest answer by William Portuese, MD
Question viewed 200 times
Tags: candidate, removal, strut, uncomfortable

These were placed in a primary. I asked the doctor to narrow my tip & he indicated he'd use a cephalic trim and dome sutures. However, I received these uncomfortable struts bc he felt my cartilage was "weak". 5 yrs later I still find them uncomfortable and I have significant tip asymmetry and alar retraction. I want a revision but docs seem scared of these grafts. I also have a columellar strut which is awkward when kissing. Is there any way to undo this?

7 answers to Can Lateral Crural & Columellar Struts Ever Be Removed?

+1

Can Lateral Crural & Columellar Struts Ever Be Removed?

I have performed Rhinoplasty and Revision Rhinoplasty for over 20 years and IMHO, yes these grafts can be removed and the nasal tip made more symmetric but exactly how thata's going to be done will be determined by photos showing the current state of your nose. Views from the front, both sides and base views are the best. Alar retraction, IMHO, it best addressed as a separate local procedure (typically done at 6-9 months post Revision Rhinoplasty) using a composite skin... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon

drfrancispalmer.com

+1

Lateral crural & columellar strut grafts can be removed

Columella struts can simply be removed by exploring the tip, undoing any sutures that may be present, and removing the implant. We have used several grafts during revision rhinoplasty surgeries. Lateral crural grafts can also be removed when needed.
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Removal of Lateral Crural and Columellar Struts

Experienced surgeons are not 'scared' of the columellar and lateral crural struts. However, be careful to select a good revision surgeon. If you do have weak cartilages you could have some nasal collapse if you remove all the support provided by the cartilage grafts. Your surgeon will need to determine if your cartilages are weak, and if the grafts need to be reduced or repositioned to correct the tip asymmetry, alar retraction, and the stiff columella.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon
+1

Secondary rhinoplasty

Invariably secondary rhinoplasty involves modification of the supporting structures. Modification ranges from removal to repositioning to a combination of the above.
Jay M. Pensler, MD

Chicago Plastic Surgeon

www.plasticsurg.org

+1

Unhappy with nasal tip grafting

Dear patient, You need to visit an expert revision rhinoplasty surgeon in your area to assess your nose. An experienced rhinoplasty surgeon will not find it difficult to remove previously placed nasal grafts and deal with complex noses like yours. Five years has pasted since your primary surgery and you’re not still happy with the results, therefore a revision rhinoplasty is indicated. If you need name of an exert rhinoplasty surgeon in your area, please let me know. I would be... more
Kevin Sadati, DO

Orange County Facial Plastic Surgeon

www.galleryofcosmeticsurgery.com

+1

Removing lateral crural and columellar grafts

Your previously placed grafts can be removed though whether this will fix the problems you describe is hard to say without seeing your nose. Asymmetry and alar retraction can occur after rhinoplasty and can be related to many different causes. Revision rhinoplasty can address these concerns, though it is important to maintain your nasal support afterward.
Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon

www.drlamperti.com

+1

Removing grafts from a previous rhinoplasty

A seasoned revision rhinoplasty surgeon is rarely scared of previous graft placement; almost any graft can be removed, but with caution and meticulous dissection so as not to cause injury to other structures. Most grafts do not feel uncomfortable, but may look too full or visible. Alar retraction is rarely caused by the placement of a graft, but is more likely due to too much resection of the cephalic margin of the lower lateral cartilages or the vestibular skin underneath them, or by... more
Russell W. H. Kridel, MD

Houston Facial Plastic Surgeon

www.todaysface.com

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