Columella strut revision question

hey docs. I have a very very uncomftortable columella strut. It clicks and grinds and even gives me problems when I eat. I can feel it when I push my fingers around my upper lip. It definitely is problematic. I got a few opinions and some docs say it should be trimmed and some say it should be trimmed and attatched to the remaining L strut. If it is not sutured to the L strut does that mean it will not go successfull. Scar tissue is the real deciding factor anyway. Rhinoplasty master plz answer

Doctor Answers 5

Columella strut

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.

San Diego Plastic Surgeon
5.0 out of 5 stars 27 reviews

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.

Moneer Jaibaji, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 15 reviews

Columella strut revision

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

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 14 reviews

Columellar strut

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.

Arian Mowlavi, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 68 reviews

Columellar Strut

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!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 90 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.