Columella Strut and Crease

Hello, I had a columella strut placed in my nose a year ago. Since then there is a crease between my upper lip and my nose when I smile which looks very unnatural. My surgeon said the tip would drop if he removed the columella strut so I have to accept the smile crease unless I want the tip to drop. Do you agree? Is there any method that can get rid of that crease and keep the tip upwards at the same time? Thank you. Angelina

Doctor Answers 5

I can suggest 2 options for columellar crease

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Since it has been a full year, you can consider having the strut modified (made smaller) surgically and not lose tip support; it is a minimal procedure under local anesthesia usually. You can also consider a filler such as Restylane or Juvederm for temporary improvement; Silikon 1000 is also possible for permanent correction if your surgeon is comfortable doing this.

Peoria Facial Plastic Surgeon
4.7 out of 5 stars 13 reviews

Columellar Strut and Crease

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Without examination I am speculating, but if the strut is too long or located inferiorly it could cause a crease when you smile.  Ask your surgeon about the strut position, especially if you can feel it. Fillers may hide the crease when you smile, but will the area be full when you're not smiling?

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

I'm not aware of columella-struts resulting in upper lip creases.

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Columella-struts are nearly routinely used in the tips of my patients during rhinoplasty surgery. I agree with your surgeon that they lead to a more durable tip that would be less likely to droop with time. Feel free to email your photo along with a description, and I'll be happy to share my thoughts with you.

Regards from NJ.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Collumelar Strut and Lip Crease

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Hi Angelina,

I doubt that the strut is causing the upper lip crease although I cant be 100% sure without seeing it. However, you can consider doing a filler such as silicone or radiesse to eliminate the crease.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

Lip crease after rhinoplasty.

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You can fill the crease with Juviderm and this will allow you not to have to change the nose in any way. Though it only lasts a year, most patients have other lines that need filling.

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