I will be having a revision for a columella strut that is sometimes palpable and that gets caught on something. it is very uncomfortable and I cannot live like this nor did I pay for a problem. I am very worried though. Will trimming this strut make my tip droopy. I have dome sutures and onlay graft and shield graft though..? Does the columella strut directly increase the tip heigh and projection or just "strength". I am very worried because if it droops down then my nasal bones will show :(
Answer: Revision rhinoplasty definitely is in order. Dear apple1937 in Beverly Hills, California: Wow, you have a lot going on there. If the strut is causing an unsatisfactory appearance and breathing problems, then of course there has to be some revision surgery done there. Particularly because it is uncomfortable, you want to get this done. Regarding whether or not turning the strut will “make my tip droopy,” it is hard to say without feeling it. Dome sutures and onlay grafts and shield grafts are done to strengthen the tip, and hopefully some manipulation or partial removal of the strut will not compromise the strength of that part of the nose. The surgeon will be able to figure that out. You asked whether the columella strut directly increases the tip height and projection or just strength, and my answer is that frankly without feeling it and carefully examining it, I can’t answer that questions. Your concerns are valid. You need to have consultations with surgeons who are highly focused on nasal issues, both surgical and non-surgical. It may be that you can be helped by a combination. Sometimes that is necessary to get the optimal result. When you go for consultation, be sure to have computer imaging. Likewise, prepare for the consultation by composing a written list of questions. You want to stay focused and help the doctor address all the issues that concern you. Be sure to bring your operative reports and photographs taken before and after the prior procedure because that is going to be very important to the surgeon to understand what has been done, why it was done, and how it was done. Review a lot of websites as you decide which surgeons to consult with. You should see a large collection of before and after photos including primary rhinoplasty, revision surgical rhinoplasty, non-surgical rhinoplasty, and non-surgical revision rhinoplasty. You want to be in the hands of someone who has a broad range of talent using all the modalities available. Bring a friend or family member because there is going to be a lot to discuss and you don’t want to have anything missed. Best wishes, Robert Kotler, MD, FACS Over 4,500 nasal procedures performed
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CONTACT NOW Answer: Revision rhinoplasty definitely is in order. Dear apple1937 in Beverly Hills, California: Wow, you have a lot going on there. If the strut is causing an unsatisfactory appearance and breathing problems, then of course there has to be some revision surgery done there. Particularly because it is uncomfortable, you want to get this done. Regarding whether or not turning the strut will “make my tip droopy,” it is hard to say without feeling it. Dome sutures and onlay grafts and shield grafts are done to strengthen the tip, and hopefully some manipulation or partial removal of the strut will not compromise the strength of that part of the nose. The surgeon will be able to figure that out. You asked whether the columella strut directly increases the tip height and projection or just strength, and my answer is that frankly without feeling it and carefully examining it, I can’t answer that questions. Your concerns are valid. You need to have consultations with surgeons who are highly focused on nasal issues, both surgical and non-surgical. It may be that you can be helped by a combination. Sometimes that is necessary to get the optimal result. When you go for consultation, be sure to have computer imaging. Likewise, prepare for the consultation by composing a written list of questions. You want to stay focused and help the doctor address all the issues that concern you. Be sure to bring your operative reports and photographs taken before and after the prior procedure because that is going to be very important to the surgeon to understand what has been done, why it was done, and how it was done. Review a lot of websites as you decide which surgeons to consult with. You should see a large collection of before and after photos including primary rhinoplasty, revision surgical rhinoplasty, non-surgical rhinoplasty, and non-surgical revision rhinoplasty. You want to be in the hands of someone who has a broad range of talent using all the modalities available. Bring a friend or family member because there is going to be a lot to discuss and you don’t want to have anything missed. Best wishes, Robert Kotler, MD, FACS Over 4,500 nasal procedures performed
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CONTACT NOW May 22, 2016
Answer: Columellar strut revision Strut length (height) and position can lead palpability and "clicking" when it encounters the bone of the nasal spine. The strut does serve all of the purposes you mentioned though. It helps with tip support, projection and rotation - therefore, altering the strut may impact each of those aspects of the nasal tip. Please discuss these concerns with your surgeon so that you are both on the same page about your desired outcome.Good luck.
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CONTACT NOW May 22, 2016
Answer: Columellar strut revision Strut length (height) and position can lead palpability and "clicking" when it encounters the bone of the nasal spine. The strut does serve all of the purposes you mentioned though. It helps with tip support, projection and rotation - therefore, altering the strut may impact each of those aspects of the nasal tip. Please discuss these concerns with your surgeon so that you are both on the same page about your desired outcome.Good luck.
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May 22, 2016
Answer: Dealing with a long columella strut Yes it can be made shorter. Yes that should help with it catching on the bone above your teeth on you maxilla (the anterior nasal spine). Yes that might decrease tip support. But, there are ways to counter act that. Also, you dorsum is still a little over projecting. Reducing that would make any loss of tip support less of an issue.
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Answer: Dealing with a long columella strut Yes it can be made shorter. Yes that should help with it catching on the bone above your teeth on you maxilla (the anterior nasal spine). Yes that might decrease tip support. But, there are ways to counter act that. Also, you dorsum is still a little over projecting. Reducing that would make any loss of tip support less of an issue.
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