I have had several patients in the same situation who had columella struts placed by other doctors and they are miserable with them. I say take it out altogether. I've never been a fan of the struts and think they do more harm than good in many cases.
Columella strut revision question
Hi Katerina and thank you for your questions. The columellar strut is rarely sutured to the caudal septum. Whenever a columellar strut is placed the patient can feel the columella is thick and they can feel the strut moving. The auction of the stunt is to support the nasal tip from collapsing. If it is too symptomatic then I think you should discuss it with your surgeon or get a second opinion.
It is difficult to know the exact problem without a thorough examination and reviewing the details of your previous operation. Often times, columellar struts are not sutured to the L strut of the septum and are held together by being sandwiched and sutured to your lower lateral cartilages. In case of a rhinoplasty where a strut is used together with spreader grafts, the columellar strut can be supported by the two spreader grafts on each side. Regardless, the strut should be well supported and ideally not freely mobile. You may require a revision or secondary rhinoplasty which is more challenging due to scar tissue and possible need for more cartilage which may be taken from place other than the nose and is frequently performed in our office. It is best to have an in-person examination to determine the cause of your problem and to create a treatment plan that can solve this issue. Hope this helps!
Johnson C. Lee, MD Plastic Surgery
It is not uncommon to not suture the columella strut grafts; in fact, this strut is sometimes called the "floating" columellar strut graft; The fact that you can feel it is concerning because it should be sandwhiched between your lower alar cartilages; Whether you need to trim this graft is dependent on your nasal tip position and support. Please provide photos.
Hello,Strut grafts are rarely sutured to the caudal septum, or any other fixed structure, and very few people have your problem. Without an examination, the best solution for you is unknowable. Go see a few surgeons.Best of luck!