I've heard a columella strut is used for tip support and to prevent nasal collapse, can it make the nose look unnatural?

Are there other forms of tip support that can help prevent nasal collapse an look natural? Or other techniques used to prevent a nasal collapse when tip work has been done to refine the tip on thicker skin? As well as when work has been done to lift a droopy tip slightly upwards. And other refinments like ostemosis to narrow a bridge. Is a columella strut always nessary?

Doctor Answers 7

Columellar strut

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You are right - A columellar strut is one method to control the nasal tip projection and position.  However, there are other methods to support the tip as well and shape the nostrils.  A columellar strut is not always needed and although it is a very good method to control the nasal projection, it has downsides and is not always needed.

It is difficult to describe what is needed without an actual exam or photos.  We would be happy to see you and discuss your concerns as well as different strategies to achieve the results you're looking for.

Best wishes,

Christopher C. Chang, MD

Washington DC, Maryland, and Virginia

Washington DC Plastic Surgeon
5.0 out of 5 stars 20 reviews

Supporting the nasal tip

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A columella strut graft is just one maneuver that can help with nasal tip support.  The size and shape of the grafts can vary and what size graft, if any, will depend on the needs of your particular nose.  The columella strut grafts are not routinely used to provide contour to the nasal tip and thick nasal tip skin may require other forms of cartilage grafting in order to create the nose that you desire.  A thorough consultation with an experienced nasal surgeon would be extremely helpful and very informative for you.  Best of luck!

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

rhinoplasty procedure

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 A columella strut is not used routinely  in our practice.  We have removed more of them than we have placed due to complications we have seen with them.  They do not prevent nasal collapse.  A full set of photographs  are required to make a determination in addition to an in-person examination to discuss a difficult surgical procedure.  Rhinoplasty is one of the most difficult procedurse to perform correctly in the entire field of cosmetic surgery, so it is very important to choose surgeon based on extensive experience.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews


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Dear realgirl,

     Front and side view pictures would have been very helpful. Rhinoplasty is a complex procedure and as the expression goes - " there are many ways to skin a cat", meaning that there are varied  techniques to achieve beautiful and natural looking nose. 

   I have been in practice for over 29 years and performed  rhinoplasty surgeries on hundreds of patients. I have never used columella strut on any of my patients. I personally prefer the suture technique for nose stability , tip lengthening and tip definition.

   Not all results are the same because experience, skills and aesthetic eye are critical for good outcome. So,  do your due diligence and choose your surgeon  wisely, in order to avoid bad result and need for corrective surgery.

   Always, consult with experienced board certified plastic surgeons who perform their surgeries 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 with natural look.

                           Best of luck,

                                        Dr Widder


Columella Strut in Rhinoplasty

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A columella strut, like any surgical technique, can be overdone or used in the wrong place. This is one of many techniques which can be used to provide tip support and projection. What is best for you depends on your specific issues and anatomy. A personal consultation where a surgeon cab not only look at your nose, but feels the cartilage and the support present, is the only way you can find the right answer.

Ira D. Papel, MD
Baltimore Facial Plastic Surgeon
4.9 out of 5 stars 36 reviews

Columella struts

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Yes, a columella strut can make the columella region appear wide and can make the nose feel very stiff, or even click with movement.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Columellar strut

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Hello and thank you for your question. There are many techniques used to enhance tip support and prevent collapse other than just a columellar strut.  The best procedure really depends on your individual nasal anatomy.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. 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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

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.