What could be causing pain after I felt columella strut graft move?

Good Morning! The fullness on the medial part of your cheek is interesting. The columella is located at the underside of the nose and any infection or damage tends to show near the area, upper lip, septum, or nasal tip. In this case, I would watch the swelling over the next 1-2 weeks to see if there's any improvement. Antibiotics by mouth and topical cream may help. A steroid injection could be useful to reduce inflammation. It's good you followed-up with your surgeon to ensure the graft is stable. Hope this helps!

Cartilage grafts can live and shift because they usually just sit in scar tissue rather than become fixed to other structures of the nose. I don’t know if your strut is doing any good but if it bothers you a lot it is simple to remove and probably won’t affect the appearance much

Hi and welcome to our forum!
You have already been evaluated for your recent injury, and the graft is apparently structurally sound.
The buccal branch of the trigeminal nerve provides sensation to the area you circled. If the nerve is traumatized, swelling may be responsible for your sensory disturbance. This phenomenon should resolve within 6 weeks or so. If it persists, reevaluation by your surgeon is recommended.
Best wishes...