It is incorrect if a doctor tells you your strut can not be addressed with closed rhinoplasty. It is more likely that the doctor favors the open approach or has only been trained in open rhinoplasty. A tip strut can be readily approached with closed rhinoplasty which is through the same scar along the sides of your columella and inside the nostrils but without crossing the front where you might end up with a noticeable permanent scar. If you had a prior open rhinoplasty than the question arises as to why not just use the already present scar to reopen your nose? I have rather opinionated views on the subject and they involve whether or not you need a scar revision of that possibly unsightly scar. Even if you need a scar revision I probably would not reopen the nose because I feel I can get a better sense of aesthetics and have less post op swelling by not opening it again. This is the minority view since most doctors have lost the desire to perfect the art and craft of closed structure rhinoplasty. Closed rhinoplasty has been traduced as being synonymous with reduction of bone and cartilage and there is a misconception that one must make a scar on the columella to peel the skin off the nose in order to restructure the tip and secure cartilage grafts, I was very well trained in open rhinoplasty yet rarely do it and my results compare well with anybody and a visit to my web site will be evidence of work well done, Does it take effort and commitment to figure out and perfect restructuring through a closed procedure…yes. Is it hard to find elegant work in complex noses via closed technique…yes. Does an open approach allow an occasional rhinoplasty surgeon to improve their results…probably yes. Does open technique improve the ability to assess the problem and plan the procedure and deliver a holistic aesthetic success…No. Independent of the approach, please get several opinions from doctors who can demonstrate evidence of their success with the problem you have. Peace be with you.