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Collumellar Sutured with an Overlap or Just Swelling? (photo)

The day after my surgery I noticed the wound seemed to be sutured oddly, it wasn't in line with the bottom of the collumellar. I assumed this was normal, maybe from the swelling, but now as most of the swelling is gone, bar the tip, it hasn't improved, it's healed with a step. I am 16 days post op.

I am worried it will stay this way. Am I just not giving it enough time? Is this a normal response with swelling on the upper collumellar? Or will I need to consider surgery to correct it? Many Thanks.

Doctor Answers 8

Collumellar Sutured with an Overlap or Just Swelling?

This is the #1 compliant of the open rhinoplasty technique - the scar of the collumella.  Revision is needed in your case in my opinion. 

Miami Plastic Surgeon
4.5 out of 5 stars 77 reviews

6330 Manor Lane
Miami, FL 33143

Columellar stair step scar from an open rhinoplasty

The columellar stair step scar is most likely due to swelling.  If it does not resolve over the next 3 months then a revision may be needed.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 13 reviews

3096 Peachtree Industrial Blvd
Duluth, GA 30097

Columella swelling

Swellng may lead to this exact issue. It is not overly common but can happen. If it doesn not improve, a scar revision may be necessary.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 20 reviews

1049 Fifth Ave
New York, NY 10028

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Collumellar step

Any incision in surgery will result in some swelling and the collumellar is no different.

An appearance of a step in the incision is common and is most often due to swelling. It may take months for this to settle and patience is the key. If it does not fully resolve it is worth discussing with the surgeon as a revision of the scar may benefit in creating a better esult.

Jeremy Hunt

Jeremy Hunt, MBBS, FRACS
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Columella step

How far are you out from surgery?  Hopefully it will decrease further over time.  In some cases  revision may be required but should be delayed until healing is complete (one year).  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
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Collumealla sutured with over lap

Many thanks for the question.

The short answers is poor stitching.I am sorry for it.I hope it settles down

Take care

wish you good luck

Ashok Govila, FRCS, MCh, MS
Dubai Plastic Surgeon
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Columella incision revision or just swelling?

Dear Spinifex,

 You do have a small step and I am not sure how far post surgery you are however if this is a fairly recent procedure then this should get better with time. If not then after the proper healing time this may be easily corrected with revision. Discuss this with your surgeon to help put your mind at ease during this recovery phase. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
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Collumellar Sutured with an Overlap or Just Swelling?

Dear Spinifex,

I have not seen this, but it is not out of the realm of possibilities that you have swelling in this area.  More likely, is deep sutures that are causing this, and will slowly go away as the suture dissolves.  If it does not go away, then a scar revision is in order.

Best Wishes,

Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
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Scottsdale, AZ 85260

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