Left with Only 8mm L-strut After Rhinoplasty. Should That Be Corrected?

asked 1 year ago by cansomeonehelpme in Winnipeg, MB
Latest answer by Richard W. Fleming, MD
Question viewed 279 times
Tags: revision, strut

After reviewing an old operative report i noticed the surgeon mentioned he used and removed cartilage from my nose but left me with a good 8mm L-strut. I read online that L-Strut should be at least 15mm. I need revision for nasal valve collapse, but should my L-strut also be made larger with rib grafts to equal 15mm?

10 answers to Left with Only 8mm L-strut After Rhinoplasty. Should That Be Corrected?

8 mm L-strut

The width of the strut after rhinoplasty does depend on the thickness and strength of your cartilage. Ask that question to the surgeon who is doing the spreader grafts for valve collapse, but it is probably not necessary to graft the septum if you're not having any problems.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Allow your surgeon to be judge of integrity of nose

I would allow your current surgeon to assess the integrity of your nose and recommend the need for additional support to the tip and dorsum if needed.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Support after rhinoplasty and the L strut

Your question takes me back about 30 years in rhinoplasty. The L strut refers to the amount of cartilage left in the bridge or dorsum of the nose and the lower or caudal portion of the septum which forms an L tipped to the side about 45 degrees. In a day it was considered best to leave a one centimeter L strut to provide adequate septal and nasal support. The concept still makes sense today, preserve what can be saved for support, and reinforce with cartilage grafts where needed. Your 8... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

8mm L strut

It is true that your strut is a little narrower than what is customarily left - but if you aren't having any problems with nasal dorsal collapse, I wouldn't worry about it. (are you sure it was the L- strut or was it a cephalic trim where they left 8mm?) The customary 15mm is just to make sure that there is enough cartilage to support your nose. However, if you are concerned or just have a burning desire to know why he/she left 8mm, I'd recommend you ask your... more

Catherine Huang-Begovic, MD
Beverly Hills Facial Plastic Surgeon

Should an 8-mm septal strut be revised during surgery?

Although 8-mm is narrower than what is generally recommended for strut width, that doesn't necessarily mean that the strut itself needs to be augmented during your surgery. Cartilage quality or strength also plays a large role in how well the remaining strut will hold up. It the cartilage isn't strong enough you may have septal buckling and loss of tip support. If these problems aren't occuring then you may be okay (other than the valve collapse issue, of course). It... more

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

L-Struct Support of Nose

Hi Can, In general rhinoplasty surgeons dogma has been to leave a 1 cm L-struct. That is in general. If the septal cartilage is weak, it should be a little larger, if the cartilage is strong, perhaps one could get away with an 8 mm struct. Only your rhinoplasty surgeon can determine whether you have enough support. I would not jump to rib cartilage grafts based on an op report, but rather on your physical exam and how well supported your nose is. Good... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

L-strut size

In general, the L-strut should be approximately 1 - 1.5 cm wide to prevent dorsal saddling and tip ptosis or deprojection . The absolute size, however, depends upon the thickness and intrinsic strength of each patient's septal cartilage, so that 8 mm may be perfectly fine to support some noses but not others.

William D. Losquadro, MD
Mount Kisco Facial Plastic Surgeon

L-strut

The L-strut can vary in width and height, but usually you want to maintain at least a 1cm or larger piece . Ther is just more of a risk of collapes with thinner struts.

Steven Wallach, MD
Manhattan Plastic Surgeon

Nasal L-strut Size

The recommendations on the size of the nasal L-strut will vary. I have seen recommendations range from 8 to 15 mm. In structural engineering, the weight or forces a strut can bear will vary depending on several factors - including the width, length and thickness of the cartilage strut. Therefore the width is only one factor. Another factor to consider is the cartilage rigidity - a tissue characteristic of the cartilage itself. If your plastic surgeon used... more

Daniel Reichner, MD
Newport Beach Plastic Surgeon

Left with Only 8mm L-strut After Rhinoplasty. Should That Be Corrected?

Your question is so very specific that it would be inappropriate to respond without an in person nasal examination. See in person consultations. But yes a larger strut is needed. From MIAMI Dr. Darryl j. Blinski