What is causing the clicking problem? Is it my columella strut?

Hello,The columellar strut is an 'interposition' graft that is sutured between the two medial crura of the tip cartilages, which occupy the portion of the nose called the columella.  This part of your nose is not securely fastened to any non-moving, stable parts of your nose or face like septum or maxillary bone. Instead it glides around, and that is why most people can move the tip of their nose forward and back.Your graft, if too long or if not properly secured between your medial crura will 'catch' the edge of the septum, making that clicking sound/feeling. Either trimming the exposed portion of graft, restitching it so that it isn't so protuberant, or tightening the membranous septum so that it is less mobile will likely lesson the possibility of future clicking. I hope that this made sense!Best of luck!

Dear apple1937,The C-strut can move around, even if we place it in a pocketThe pocket is a soft tissue pocket so the C-strut can still be mobile (it is like moving around your skin)Trimming the point of contact can help, or securing it to the septum can help tooYou just have to be careful because moving the C-strut can also affect tip positionIt sounds like your surgeon has it handled and will take care of it appropriatelyBest,Dr. Nima

We place a columellar shoring strut in nearly all of our rhinoplasty patients to maintain tip support, and sometimes to aid in tip projection and rotation. C-struts are typically placed in a pocket between the medial crura, and are suture fixated. If you move your columella with your thumb and index finger and notice clicking, there may be a relatively simple remedy. We have had success dealing with occasional clicking C-struts by trimming the bottom of them where they may be rubbing against bone. The approach may be through a small incision between your upper lip and gum, and there is typically fast recovery and little, if any, downtime.Hope this helps, and wishing you well.Dr Joseph.

Recommend no manipulation of your nose and see your surgeon for evaluation. There are a number of procedures that can be performed on the nose which may include cartilage grafting which may feel mobile if is placed at the nasolabial angle.

You have to understand. Cartilage is flexible. It moves. Just because it is in a pocket does not mean it will stay completely still. Sure it could be too long. I have never examined you so I would not know but just answering your question you have to understand cartilage can move especially in the area of the columella because the tip of the nose is all cartilage and soft tissue, no bone. 

Columellar strut grafts can come in many different shapes and forms; sometimes they are fixed and some times they are placed free floating. The decision making requires appreciating whether the nasal tip is crooked, well projected etc. Most popular columellar graft that is used during open rhinoplasty is the free floating graft which is used for a nasal tip that was not crooked and one that had appropriate projection preoperatively. The floating graft is placed to make sure that your tip keeps its preoperative position and that does not fall.

Thank you for the question and though an examination is needed it sounds like the strut needs to be better secured to the nasal spine or shortened.  So see your surgeon.Dr. Corbin