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Removing columellar struts?

I had a rhinoplasty to reduce the width of my nose from the front and was explicit about not wanting to lose any length at all cost. I'm 4 mo PO and it seems as though the bottom portion of my nose has just been "removed", and my op report says that the inferior portion of my septum was excised. Is it possible that it's the struts alone creating this foreshortened tip? If so, is it reversible??

Doctor Answers 5

November 30th, 2013

Removing columellar struts?

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If the caudal septum has been reduced and has caused shortening, extension grafts can be placed.

Kenneth Hughes, MD

Los Angeles, CA

Learn more: http://www.hughesplasticsurgery.com/Rhinoplasty.php

Kenneth B. Hughes, MD
November 28th, 2013

Columellar struts in rhinoplasty

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Columellar struts are meant to counteract the forces that drop your nasal tip with time. I would not recommend removing the columellar struts. The decreased length of your nose is likely due to the resection of the septum. A picture of your nose would be very helpful in this case because there may be residual swelling contributing to the "removed" look of your nose and if this is the case time may be all that is needed to correct the problem. I would also talk to your surgeon about your concerns.

Kristina Tansavatdi, MD

Kristina Tansavatdi, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

November 28th, 2013

Septal Resection is Cause of Nasal Tip Shortening

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A columellar strut is not the culprit of having lost tip length. If anything one of their benefits is to try and prevent loss of tip projection. The removal of the caudal end of the septum is the culprit and this can be reversed by cartilage grafting for tip lengthening.

Learn more: http://www.eppleyplasticsurgery.com

Barry L. Eppley, MD, DMD
November 28th, 2013

Shortened nose

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It is difficult to answer this without seeing you in person. It is impossible to answer this without pre and post op photos as well.

Steven Wallach, MD
November 28th, 2013

Columellar struts are used to elevate and rotate the nasal tip upward

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Thank you for your question. Of course you need to discuss your concerns with your plastic surgeon.

Columellar struts are important part of rhinoplasty and are designed to prevent collapse or drop of the nasal tip and to rotate the nasal tip upward. If they are removed I would expect the nasal tip to drop and the inferior portion of your nose might retrude more.

Resection of the inferior septum can cause lessening of columellar show from the side.

Filler injections or a cartilage graft can plump the columella and may improve the area of your concern.

Learn more: http://drseckel.com/surgical-procedures/result-oriented-rhinoplasty-nose-surgery/

Brooke R. Seckel, MD, FACS

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.