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Will Columella Stiffness Resolve After Rhinoplasty?

I had an open primary Rhinoplasty 6 mos. ago, and my tip is still pretty stiff and swollen. My ps placed a strut graft in my columella, narrowed my nose and removed a bone spur, which was blocking my airway. He said, this will all soften with time and that my columella will eventually return to normal. Is this really the case? It's been 6 mos. and no change! I'm afraid that my columella/tip will remain firm and swollen looking. I had two steroid shots because of thick skin!

Doctor Answers (20)

Columellar issues after Rhinoplasty

+3

Open Rhinoplasty creates more stiness in the columellar area because the skin in this area is elevated as part of the Rhinoplasty.  The lymphatic vessels hook up at 6 months post op which should speed along the softening in this area.


Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 12 reviews

Tip stiffness after rhinoplasty

+2

The tip will be stiff for a while due to the skin swelling, but the columellar strut can also create some stiffness. This should settle out with time but may take a year or so after surgery. The strut is there to help prevent excessive loss of of tip support after surgery.


 

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Numbness and stiffness after rhinoplasty

+1
In general, almost all noses are numb right after a rhinoplasty. In most cases its the tip that is numb, but this numbness can extend down to the upper lip, and in rare cases some of the teeth. There are nerves that are cut and stretched during a rhinoplasty, and it takes a long time for those nerves to start working again. This is true of an open as well as closed rhinoplasty, although it tends to be more extensive in open rhinoplasty. This could also be more extensive if a septoplasty is performed at the same time. A revision rhinoplasty is a much harder surgery with a lot of internal scarring to cut through. This can also be a reason for prolonged numbness. This, along with the swelling, gives you a stiff, plastic type feel, and can give you an odd smile. However, the nerves will start working and again, and your nose stiffness will go away with time. As the nerves grow back, you may feel some tingling, itchiness and on occasion pain. This takes in most cases months, but can take years in rare cases. Extremely rarely, the numbness is permanent, although I have never seen such as case.
Best Wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

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Will Columella Stiffness Resolve After Rhinoplasty?

+1

Be patient. It takes months to years for grafts to soften. Please don't expect things to return exactly the same as before, afterall, the grafts were placed to add structure and support (remember, this is a good thing).

Anand D. Patel, MD
Austin Facial Plastic Surgeon

Swelling After Rhinoplasty

+1

Swelling after an open rhinoplasty can take a year or even longer to completely resolve. What you describe could certainly be swelling or may be the columellar strut. For now, I would agree that waiting is a good option and see how things turn out at about a year after surgery.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
4.0 out of 5 stars 13 reviews

Stiffness after Rhinoplasty

+1

It is possible you still have temporary residual swelling that will resolve over the next several months. This is more common when grafts are placed in thick-skinned tips . Be patient and continue to consult with your surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Columella soften?

+1

It's really hard to predict when the swelling will go down.  However, i'd give it some time.  The function of the strut is to make the tip more stiff - so if it was a thick piece, it will probably not get much softer.  Only your surgeon knows what he did specifically in your surgery.  I'd recommend keeping in close contact with him/her so you can get all your questions and concerns answered.

Dr. Cat Begovic M.D.

Catherine Huang-Begovic, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 8 reviews

Rhinoplasty and columella stiffness

+1

It is not unusual, following a rhinoplasty, to experience nasal tip and columella  swelling and stiffness for one or even two years following the surgery.  this is especially true if one has had a cartilage graft placed.  This should gradually improve, but it is going to take more time.

Vincent D. Lepore, MD
San Jose Plastic Surgeon
5.0 out of 5 stars 20 reviews

Stiff or Firm Nose after Rhinoplasty Surgery

+1

Hi SandraB,

The nose typically feels stiff or firm after rhinoplasty surgery, mostly from swelling. Patients who have an open rhinoplasty with an incision in the columella (skin between the nostrils) generally have more stiffness as compared to patients who have closed or endonasal rhinoplasty. Other factors that contribute to nasal tissue stiffness include cartilage grafts and type of cartilage. Rib cartilage used in rhinoplasty is obvious by the way the nose feels, as it's generally much stiffer. 

Most stiffness after rhinoplasty will gradually resolve & soften over time. Approximately 80% of the swelling resolves with a couple months. However, the remaining swelling takes at least one year, if not longer, to resolve. Speak with your rhinoplasty surgeon regarding any concerns you have. Only after a comprehensive evaluation can a surgeon help determine appropriate options for you. Best of luck.

Dr. Chaboki

 

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Stiffness of tip and columella after rhinoplasty usually resolves.

+1

After grafting a columella, you can expect stiffness for 1-2 years.  Some patient soften sooner and some later.  It may always be more stiff than is was prior to surgery.  Swelling is the same story.  Even is the graft was stiff a year from now, I would typically not recommend removing it.  An open or structure rhinoplasty involves creating a stable strong structure that will last for your life.  The is a different philosophy that a reduction type procedure which may degrade over time.  SJR

Stephen J. Ronan, MD, FACS
San Francisco Plastic Surgeon
4.5 out of 5 stars 4 reviews

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.