Columellar Strut in Rhinoplasty
Q: Dr. Eppley, I had a columellar strut from a rhinoplasty that caused a smile issue. I had the strut removed last year and my smile went “almost” to normal. It was a free floating strut. I am not sure if the doctor removed all of it or left a bit at the bottom. I am feeling some hard tissue there. Doctors say it is fibrotic tissue, but one said it is a strut remnant. The doctor who did it said he removed it all. Is there an imaging technique with which I can prove what is what? CT scan maybe?
A: No imaging can see a cartilage strut in the columella of the nose in any accurate way. If the doctor said he removed it I would believe him. I would expect that it will feel firm and fibrous as the anatomy has been disrupted…twice. At this point if your smile is ‘almost normal’ I would consider that a recovery that is as good as one could hope. Trying to take a 90% improvement to 100% is the surest way I know to probably make it worse…or at least end up with no improvement despite the effort.
Dr. Barry Eppley