Does a columellar strut change the columella, or is it only used to support the tip? if it does modify the columella, how so?

This is a good question and the roles of a columellar strut can vary. First of all we should define what this cartilage graft is. Usually it is a piece of cartilage from the septum used to strengthen or re-position the area of the nose between the nostrils. The strut can be used to increase the projection of the tip, the angle of the nose on the face, or to straighten the area between the nostrils. In certain circumstances it can be used to help breathing problems.In it's simplest form it just creates stiffness to prevent scar or gravity from pulling the tip down. This is a very common technique used in rhinoplasty with many variations.

The columellar strut is primarily used to support the tip but it has other functions as well. It helps to position and stabilize a weak tip. It helps to properly position and support the placement of tip grafts. It also can change the angle between the columella and upper lip.

Hello and thank you for your question. If it is placed properly, a columellar strut should support the tip without adversely affecting the shape or size of the columella.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

A properly placed columellar strut is used to increase tip support. Sometimes it widens the columella, but if placed correctly, it usually does not. It can also be used to straighten the columella when the underlying cartilages are weak, buckled, or deformed. 

Dear Rhal,    In Rhinoplasty surgery there are many techniques that can  achieve  the goal of beautiful nose, as it is said - "There are many roads that leads to Rome". The columella strut can be use for strength or for elevating the nasal tip or increase the columella show. In my practice I do not use columella strut but rather use sutures and cartilage grafts to obtain the same goals.                                                                                                                                                   You have to realize that not all results are the same, because experience, skills and aesthetic eye are critical for good outcome. So do your due diligence carefully and choose wisely.                                                                   Always, consult with experienced board certified plastic surgeons who do lots of rhinoplasty surgery in accredited surgery center for your safety. Most importantly, check the before and after pictures to make sure that they are numerous, consistent and attractive.                                           Best of luck,                                                                 Dr Widder

typically, a properly placed columellar strut supports the tip but doesn't change the tip or columellar shape. In some patients with a retracted columella, a strut can plump the area, due to its supporting effect, especially when it is sutured in place. But in those patients, the effect is desired. 

The columella strut is used to support the tip structures and can make the columella appear wider...

  Any time of graft is added somewhere in the nose, it does change the structure. Adding a columella strut makes the entire columella wider, thicker, more prominent, and stiff. That's the purpose of the  columella strut. In our practice, we rarely use them.