Can I get a columella strut revision?

Question

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

Ronald J. Edelson, MD · Answer

The columellar strut is overused and over rated. You are not the first person to complain that it is uncomfortable. The columellar strut serves very little purpose in most cases. I have taken many out over the years and nobody ever asked for it to be put back in. If removed the tip will not drop if other simpler techniques are used.

Samuel Lin, MD, FACS · Answer

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

Barry M. Weintraub, MD, FACS · Answer

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.

Tanveer Janjua, MD · Answer

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

Jonathan Pontell, MD, FACS · Answer

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.

Can I get a columella strut revision?

Answers (8)