I had open Rhinoplasty 7 weeks ago and I am concerned about the columellar strut. I can feel the distinct ridge of the strut extending far into my upper lip. Also, when I try to smile, the strut ridge becomes visible and a fold forms under the base of the strut. I feel that the strut extends too far into the upper lip area (far beyond the columellar base). Will this get better with time? Does this commonly happen? If I require revision, can this be done in the office under local anesthesia?
Revision Rhinoplasty for Too Low Columellar Strut?
Doctor Answers (6)
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You are still too fresh out of your surgery. Things will change and hopefully improve.
You have to look at the nose as a 3D structure. Did the surgeon place a large strut by accident or did he do it to build projection and support? You have to ask him/her this question. If its too long then the base can be clipped in the office but it may end up de-projecting your nose as well and that may not be what he or you want. In that case, you two have to consider other options to maintain the projection while still correcting the aesthetic problem that you are describing.
Don't do anything too quickly.
While it's possible that the strut extends too far, it is indeed too early in the post-op period to make any final judgments.
Even if a strut is too long, it's usually best to let the wound mature (heal) some more before shortening the graft. This avoids further aggravating an already inflamed area, but it also allows some of the structural support to "set," so to speak. If necessary--let's say after 3 to 6 months--a columellar strut can often be shortened or modified through a sublabial incision (under the lip) or even through a tiny stab incision at the columellar base.
The columellar strut in rhinoplasty
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Columellar struts will soften with time
Struts commonly start out firm and immobile and can restrict movement of the nose and upper lip. This will soften greatly with time as well as the fact th a portion of the strut will resorb over time.
Columellar Strut in Rhinoplasty Surgery
Although we always tell people to wait several months, what you're describing seems like it would be obvious. I'm not suggesting you go out and have something done immediately, but please discuss your findings with your surgeon. If a revision is necessary, it sounds like this could be done with minimal local anesthesia.
Post op open Rhinoplasty
Some important points:
1) It's too early to tell anything.
2) It's not what the nose feels like, it's what it looks like.
3) It's difficult, if not impossible, to acess the situation without knowing what was done and a clinical evaluation which is best done months after the surgery.
4) Some individuals swell tremendously while others exhibit minimal swelling, the same for the resolution of the swelling.