When a columella strut is placed during a closed rhinoplasty, there's not typically a suture to the lower lateral cartilage as that is not necessary. The approach that is used during the closed or endonasal, sometimes referred to as the scarless, approach is one whereby the surgeon makes a very precise pocket and places the strut into that pocket. If the pocket is no bigger than the strut, it cannot move and does not need to be sutured. This is one reason I prefer the closed approach since it is a lot less traumatic to the patient. I hope you find this video useful.
A closed or open rhinoplasty does not dictate whether or not a columella strut is sutured into position or not. An open rhinoplasty however does allow easier access to the area and may make the procedure easier for suturing but it can still be done through a closed approach with some effort. Hope this helps!
Johnson C. Lee, MD Plastic Surgery
A columellar struct is used to elevate the tip and give strength when the tip columella is weak. We do a lot of struts. We typically use a closed approach when the elevation needed is mild to moderate or when strengthening is needed to prevent tip ptosis in the future. We use an open approach for more significant elevation. Simply put, a larger, sturdier strut can be placed with an open procedure. Best wishes.
Columellar struts have an important role in rhinoplasty to create tip support in a stable and long lasting fashion in order to maintain tip position over time. They can be placed in both open and closed rhinoplasty approaches. Sutures are generally used to hold things together until your tissues form adequate scar tissue to keep them in place. Both approaches can have equally good results based on the individual surgeons experience.
Hello,Closed approach means little suture fixation for any grafts. At least in most surgeons hands. Why don't you go back to your surgeon and ask him? Of visit a few rhinoplasty experts. Random questions on this forum are really not helpful for you, I promise. If a loved one was sick, you wouldn't want to query the docs by internet; you'd want that loved one to be seen, so that the doc can give his best care (and best information).Best of luck!
A columellar struct can be placed through an open or closed approach . I don't use these so it would be better to discuss this with your surgeon. Struts or no struts are not important. what is important is the natural result the surgeon gets by what ever technique he uses.
A columellar strut can be placed through an open or closed approach. Sometimes they're sewn in place and sometimes they're not. It's best to ask your operative surgeon who placed it. In our practice, we rarely use them.