Columellar strut and problems? (photos)

I don't think they do very much. Certainly, they would not elevate the tip at all. And I agree, your nose has strong projection, so you don't need a strut to increase the projection.My advice: don't worry so much about just what the doctor will do inside your nose: columellar strut, vertical division, full transfixion, nasion deepening, this chisel that chisel ... If you find a surgeon whose before and after photos show the kind of results you are looking for, hire that surgeon, and don't even ask what he'll be doing inside the nose!

If you look at the classic textbook for open rhinoplasty it says to almost always put in a strut - you can't really go wrong. I feel that is not necessarily the case. There are several ways to improve support in the tip, and in my opinion they only occasionally involve using a strut. If the rhinoplasty is performed by a surgeon who specializes in rhinoplasty you will probably get a nice result, whether a strut is used or not. It can be confusing when you have so many surgeons telling you different things, but I would go with a surgeon that you feel performs rhinoplasty on a very regular basis, and whose results you like.

We are all trained a little different on how to perform rhinoplasty. It is important to always make sure the nose has good support. The 4 docs may have felt that your cartilage was soft in the tip and that you would benefit by a strut. That is something that can only be determined by actually examining your nose and pressing down on the tip-not just looking at the pictures. Struts are an important tool for the rhinoplasty surgeon. I would encourage you not to pick the surgeon based on such a detail, but look at their before and after pictures and your comfort level with them. Computer imaging is a great tool to help both you and the surgeon come to a common understanding of what you are trying to achieve.

Thank you very much for sharing your concerns with us.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

If stabilised correctly a columella strut will not click and I believe you will need one to support your tip

Good morning. Superior cosmetic plastic surgery of the nose is detailed and complex. It should always be about less-is-more, with a keen eye towards natural beauty. I can lift the tip slightly without a columellar strut and gently file the top of the nose to achieve a straight line. The columellar strut is an excellent maneuver in the right hands, but the most important part of being a surgeon is to listen to what your patient wants!  If you want only a subtle change, this is entirely possible without a columellar strut. 

A simple rhinoplasty is the best rhinoplasty. Your profile can be improved with conservative hump removal and trim of lower lateral cartilages. You will not need a columellar strut.RegardsDr. J

A columellar strut is just one tool used during rhinoplasty.  It is better at preventing tip ptosis (drooping) than actively changing projection or rotation.  It does have occasional problems with migration and clicking.  Hard-tip is a phenomenon that happens with many rhinoplasties and is a result of the normal healing process.  Ultimately, you will need to trust the advice of your surgeon.  It is good to become educated about the procedure, but rhinoplasty is not a "shopping list" procedure and the patient should not request certain surgical maneuvers of their surgeon.  Your surgeon will need to do what they think is best for your nose.  Best wishes.  

Hi. It depends on the amount of native tip support that your cartilages have. If this is adequate then it will remain stable after rotating the tip. If not you will need a graft which is not as big a deal as you are making out. It is commonly used and is not visible. I would leave the decision up to your surgeon and not fret about it too much. Regards

Thank you for your question.  In order to give a full surgical plan, I would need to see more angles of the nose, and I would need to see you in person, as well.However, in general a columellar strut can add support to a weak tip, increase what is called columellar show, and can help to increase tip rotation (move the tip upwards).  In looking at your profile view only, I would say that an increase in your nasal tip rotation would be beneficial.  It is very difficult to assess anything about the projection of your nose without seeing the remainder of your face (ie, your chin projection). There are multiple ways to achieve the above mentioned maneuvers, and this is why it is very important that you consult with a board certified facial plastic and/or general plastic surgeon who specializes in rhinoplasty.  You also may be able to achieve your results with a septal extension graft with medial crural set back, and suturing techniques to increase rotation. And yes, you may also need a slight hump reduction as well.  Again, there are multiple approaches, and all have advantages/disadvantages I hope that this helps.  Be sure you are comfortable with whomever you choose to perform your surgery.  It is a significant step to have this surgery. -David Gilpin