Columella strut closed vs open. Any suggestions?

hey docs was curious when a columella strut is placed via a closed rhinoplasty is it still sutured to the lower lateral cartlidges so is scars correctly? I am just curious what is different through a closed columella strut placement vs open?

Doctor Answers 7

Columella strut placement

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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. 

Latham Facial Plastic Surgeon

Open vs closed columellar strut

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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

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 17 reviews

Columellar strut and rhinoplasty

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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. 

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

Columella strut closed vs open. Any suggestions?

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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. 

Afshin Parhiscar, MD
Bay Area Plastic Surgeon
4.8 out of 5 stars 58 reviews

Repeat Strut Questions

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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!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Columellar strut?

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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. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Columellar strut open versus closed approach

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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.

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