My surgeon says that he will bring down my columella slightly. Currently from the side you cannot really see my columella at all, which I don't like but previously didn't know WHAT I didn't like about it...it just looks rather unnatural. It will look MUCH better if it is slightly lower. Anyway, I can't seem to find any other cases where a patient had their columella brought down. Is this an uncommon thing to do?
Is It Common And/or Simple to Bring Down Columella?
Doctor Answers (9)
Lowering the columella
It is much more common to bring the columella up than it is down. To bring the columella up trimming of the caudal septum of both cartilage and membrane is performed to trim back the columella. To give more columellar show, a cartilage graft is inserted in the columellar area from the septum to augment and bring forth the columella. This can easily be performed at the time of the rhinoplasty.
Increasing Columellar Profile Show In Rhinoplasty
It is not common to drop down the columella in many rhinoplasties, but it can be done by cartilage grafting. Several millimeters of increased columnellar profile can be obtained by either a septal extension graft or an interpositional medial footplate graft.
It is simpler to raise a columella that hangs down than to do the opposite which is what I think you are describing. Is this the result of previous surgery? To me, it doesn't seem like it's worth undergoing in either case, but it would be helpful to see photos.
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Improving nasal profile
A photograph would be very helpful in determining your specific nasal profile. If the columella is retracted then is is common to have a somewhat underprojected nasal tip or a drooping nasal tip. There are several surgical maneuvers that can be done to improve your nasal profile
Not seeing the columella a bit in profile may be due to one of several reasons. It is best to go for a consult to be properly evaluated.
It Is Common To Bring Down The Columella Of The Nose
From the side, it is an elegant appearance to see 2-4 mm of the columella. In patients that cannot see the columella from the side, it is either due to:
1) The columella is retracted or short
2) The nostril is low or hanging
This can be corrected either surgically or non-surgically.
Surgically, to bring down the columella, I use a septal extension graft with a PDS plate. This is medically terminology to bring down the columella by making the septum longer in the area. If the nostrils are low or hanging, then they can made raised by removing a small amount of tissue inside of the nose.
The columella can be make lower non-surgically by placement of temporary injectable fillers. The nostrils cannot be raised using non-surgical techniques
I hope this helps!
Non-surgical rhinoplasty may improve the columella with fillers
- I really like using fillers to increase the columella show from the profile.
- The goal is to have 2-4 mm of show on profile.
- You can also ask your provider to do a test injection with saline to show you how it will look.
This is common in black noses and less so in Caucasians. Cartilage grafts or composite grafts are used to do this. I need photos to give u a better answer.
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.