Columella strut revision?

I did not get many opinions last time I asked.I have a columella strut graft that is really uncomfortable. it goes past my actual columella and is in my upper lip area and it is bouncing around with lip movement and is grinding against something. My objective is so that I will not feel it mobile nor feel it in this area. I have gotten many opinions and most docs say if you shorten it, the tip will drop a lot. I have no clue what to do and feel depressed and hopeless? This will be 3rd op

Doctor Answers 7

Postoperative recovery after septorhinoplasty / nose surgery

It sounds as though this particular symptom from the graft has localized to an area... as it sounds as though it is persistent it may be worth a limited revisional procedure... best of luck

Revision Rhinoplasty - Columellar Strut

A columellar strut graft should not move.  These grafts are an excellent way to give projection, but they should stay in place.  If your graft is moving, it is not sewn in sturdily.  This could be revised, more than likely without decreasing projection. Tertiary rhinoplasties (third-time rhinoplasties) are detailed and complex, but are common for those of us expert in revision rhinoplasty.

Revising columellar strut

The columellar strut can be revised only in its inferior part that sits on the nasal spine and causing your discomfort. The existing scar tissue will hold the tip along with the remaining strut. Get it fixed. RegardsDr.J

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

Columella strut

Depending upon what the strut is doing for you will depend upon the post-op ramifications. If you shorten the base so it does not click, it may cause the projection to diminish.  Hard to say without an exam.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Columellar strut problem

Hi.  I disagree with the 2 prior responses.  If the strut is shortened to the proper length so that it is still giving good support, but not long enough to flip back and forth over your nasal spine which is what is happening now, then all will be good.  This is a simple issue to fix.  Good luck.

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
4.8 out of 5 stars 98 reviews

Columellar Strut Revision

Thanks for your question.  If this is your third revision, just make sure you are getting at least 3 opinions from revision rhinoplasty specialists and take your time.  There are ways to shorten the strut and keep the nose projected though it would require opening the nose again and little more work.  If you try to shorten the strut, without doing anything else to reproject the nose, then it could drop mildly.  I would try to shorten the strut and at the same time have a plan to reproject the nose to stay close to where you are now.  

Mike Majmundar, MD
Atlanta Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews

To Strut or not to Strut? That is the question.

I have never been a big fan of putting struts in every nose I do.  I am a minimalist therefore I try to work with whatever the patient has and use a strut very rarely. I have been doing rhinoplasty surgery over 32 years and have found very few patients that need a strut.  I think you probably can remove your strut and suture the medial feet of you Columella together for support. Naturally you would have to be evaluated to determine other factors.

Carlos Wolf, MD
Miami Facial Plastic Surgeon
4.9 out of 5 stars 60 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.