What is a Strut Procedure for African American Nose?

I was told by a surgeon I met that he will not cut my columella but instead use a piece of cartilage from my nose to do a strut technique. This is because I asked for a tip refinement.

What is a strut technique and is this procedure good enough to give me a nice refined nose? (I am African American) Thank you in advance for the answers you will provide me with.

Doctor Answers 8

Nasal Strut Technique

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For patients with poor nasal tip support, a surgeon will often place a cartilage graft between the nostrils. This is called a columellar strut.

While this procedure is very helpful in maintaining nasal tip projection and occasionally provide a slight lift, it does not typically create narrowing of the tip volume. For that, you need formal tipplasty involving suture modification techniques.

I have a feeling that you will be underwhelmed by a strut procedure alone. Perhaps your surgeon is discussing it as part of a more global correction. In that context, it would be appropriate.

Good luck

African American Rhinoplasty

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Hi Rita-Marie,
A cartilage strut is placed in between the cartilage (medial crura of the lower lateral cartilages) that supports your collumela. Although this is one way to add support to your tip, this will not give you tip refinement.
In my opinion, the only way to achieve adequate tip refinement in an African American nose is to perform an open rhinoplasty and use the techniques outlined below:
  1. Remove fat from the tip of the nose
  2. Add a strut and a shield graft.
  3. Re-support the lower lateral cartilages.
African American Rhinoplasty is very difficult and should be performed by very experienced surgeons. If you don't get it right the first time, revisions can be even more difficult it not impossible. Best of Luck,

Strut procedure

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Hi Rita-marie,

This is your second posting on this topic.

In the context you just presented, a droopy / plunging nose tip can be elevated to a more attractive procedure by placing a vertical support between the cartilages making up the tip and the skull bone underneath (the anterior nasal spine). Such a "strut" needs to be sturdy enough to hold things up without buckling and is commonly harvested from your cartilagenous nasal septum.

In itself, the strut will NOT give you a refined nasal tip, just a more elevated tip. The get more refinement, you would need a tip rhinoplasty, lower lateral cartilage shaping and potentially placement of tip grafts as well.

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

Rhinoplasty with strut procedure helps refine bulbous nasal tip

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A strut is a small piece of cartilage that adds structural support and tip projection to the nose to give more refinement to a thick, bulbous tip. It is a piece of cartilage placed usually in the columella or between the two lower lateral cartilages of the nose in an attempt to give more projection and narrowness to the nose. It is done frequently in our practice. Make sure your surgeon has done thousands of rhinoplasties prior to embarking on this type of a procedure.

Nose Reshaping

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What you are referring to is a columellar strut graft. This is a piece of cartilage that is placed between the two cartilages in the tip of the nose to help provide more projection. It may give a bit more definition but in your case I think you need more tip work to get the result you want.

I would recommend an open rhinoplasty to allow accurate dissection and suturing of the tip cartilages and placement of a stut graft to help.

Hope that helps you.

Columellar Strut for Rhinoplasty Tip Refinement

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A columellar strut, which may be known as strut procedure, is a piece of cartilage placed in the middle between the lower lateral nasal cartilages. This strut may refine the tip by lifting and/or rotating the tip of the nose, depending on the size, shape, and exact positioning. Strut grafts are normally created from cartilage from the septum mostly, but may also be obtained from ear or rib cartilage. Columellar struts may be placed with either an endonasal (closed) or open rhinoplasty surgery.

African American Rhinoplasty for Tip Refinement

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Based on only one photo it appears that you have a wide tip, wide ala and a wide nasal bridge. For the best result all three areas could be addressed. As for the tip, a columella strut, which is a piece of cartilage placed behind the skin separating the nostrils and attached to the existing tip cartilages to support them is only part of the approach to creating a nicely shaped and refined nasal tip in an African American. Either a closed or open approach can be done but for the best control and ultimately the best result I feel an open approach is the best way of getting predictable results. In your case this would involve identifying your existing tip cartilages, modifying them with specific suturing techniques, harvesting cartilage from your nasal septum and both supporting the tip with a columellar strut and further supporting and shaping the tip with a specifically shaped cartilage tip graft. The surgeon facing you during the consultation has a lot more information to base his approach on but in my own experience noses such as yours usually do not respond to conservative or partial fixes. My advice would be to see a few more surgeons before making any final decisions. Best of Luck  Dr Harrell

Tip refinement in rhinoplasty

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The use of a cartilage strut placed in the columella of the nose is one of several techniques used to  increase the projection of the nasal tip. It is very effective when done properly.  It must usually be accompanied by other surgical changes to achieve a great result.  For example, in your situation the width of the upper nose must be reduced to give you a more refined nose.  The strut alone will not do this.

Kevin F. Hagan, MD
Nashville Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.