My Nose is Too Short Following Rhinoplasty

You are correct that your columellar strut will serve to maintain tip projection and prevent tip counter rotation (tip drop).  Since you are only 1 1/2 months out of surgery it is possible that following the resolution of swelling that the tip may drop, but this will be minimal.  In any event, any decision for revision will have to wait for 1 year to truly evaluate the final appearance of your nose.  If the nose is substantially shortened, it can be lengthened in revision surgery utilizing "extended spreader grafts" and/or a "septal extender graft".  If you would like to discuss this in more detail feel free to contact me.  Good Luck....Dr. Corrado

Six weeks is awfully early after a rhinoplasty.  However, if your septum was shortened, then there is a good likelihood that the overshortening of your nose will be long-lived, although there can potentially be a small amount of drop in the tip as time passes.  To re-lengthen the nose, the septum has to be re-elongated.  I would be happy to discuss further.

It takes a minimum of 6 months for the tip to be at it;s final position and up to 1 year. Try to be patient and it will probably be fine.

I read your concern. You're correct: columella-strut-grafts are helpful in maintaining the position of your tip following rhinoplasty surgery. Your tip may fall a few millimeters from the effect of gravity over the ensuing months. Feel free to email your photo, and i'll be happy to share my thoughts with you.

Regards from NJ

A strut is used to maintain projection and rotation. While it is true that the strut will keep the tip from rotating, it is likely that it will fall from its current position but that may take a minimum of 6 months

I am sorry you feel that you have a short nose after surgery. However, at this point you have a lot of swelling and it is too early to say.  It may look short because it is swollen, but I couldn;t say without seeing at least photos pre and post.

The hardest part of a rhinoplasty is the wait, especially for an open rhinoplasty.  The two most important factors are swell ling and scar contracture.  Swelling in an open rhinoplasty lasts about 6 months, for a revision about 9 months.  At this point in your recovery, about 80% of the swelling is gone.  Scar contracture is generally maximal around 3 months and then begins to relax.  One of the purposes of a strut graft is to prevent scar contracture from pulling the tip of the nose down and derotating the tip position.  So, yes, the strut is preventing your tip from falling back to its original position.

At 6 weeks, it is too soon to tell what the final tip position will be, although you should be getting an idea.  The most important thing for you to do now is let your surgeon know that you are not entirely pleased with what you are seeing. It may be possible to modify the procedure.  For instance, some surgeons will place a permanent suture between the strut graft and the septum thereby locking the tip into position.  If this is the case, your surgeon could cut this stitch in the office and let the tip relax more.

A columellar strut helps to maintan tip projection. Swelling will make the nose look over-rotated, but this will improve as healing progresses.