Columellar Strut - When is It Necessary?

Rhinoplasty is a complex procedure. Even among experts there is often disagreement on what is the best procedure for an individual. So it is difficult for a lay person to decide between two surgeons what is best for them. What you should do is see who you feel most comfortable with and as long as they are a rhinoplasty expert, let them do what they feel will give you the most aesthetic result. What you should not do is compromise since you have one nose and hopefully have on operation that will last you for the rest of your life.

As a facial plastic surgeon, I perform my septorhinoplasty by the open approach. I usually harvest a strut graft from the septoplasty portion of the procedure. I prefer using the patient's cartilage rather than an alloplastic material. Depending on the approach (open vs endonasal), once postoperative swelling resolves, your tip might drop slightly. Other maneuvers such as dome suturing can narrow and project the tip and if these were not performed, your tip may appear like it dropped. I always place a strut graft to support the tip and prevent potential tip migration. It is difficult to answer whether lack of a strut graft resulted in what you see regarding tip position. Discussing with your surgeon what he/she performed would be my initial recommendation. I would enjoy entertaining any further questions once you know everything that was performed. Good luck.

 

Dr. Randall Latorre