Hello i had rhinoplasty in michigan by an experienced board certified rhinoplasty specialist. 1 and 1/2 years ago now. im very happy with the hump that was removed however i seem to have a hanging columella which looks worse when i smile. Ive recently seen the physician who performed the surgery and he said there is nothing i can do and it looks fine ....please advise i feel unhappy and ive already spent $7000 should i seek revision, and referalls for detroit michigan
Hanging Columella After Rhinoplasty 1.5 Years Ago? (photo)
Doctor Answers (7)
Well-performed Revision Rhinoplasty Surgery may be employed to improve the appearance of your hanging columella.
I read your concerns and reviewed your photos:
Your excessive nostril show appears to be from an exaggerated curvature of the medial crurae of your lower lateral cartilages. You may have a bit of alar retraction as well.
In my experience, improvement may be obtained with revision rhinoplasty. I might use an open approach, and divide your lower lateral cartilages at their angles to allow them to straighten. I might also consider placing a columellar strut to aid in columellar straightening and to add support to your tip.
You may consider consulting several revision rhinoplasty specialists to see what might be best for you.
Hope this is helpful.
I disagree with the statement that it looks fine. Your posted photos show the root of the nose at pupil instead of upper eyelid crease level, a hanging columella and possibly some nostril rim retraction. Correction would require a graft to the bridge (to raise the root of the nose), trimming of the bottom edge of the septal cartilage (for the hanging columella), and grafting with or without tip cartilage repositioning (for the nostril rim retraction).
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
Hanging Columella After Rhinoplasty 1.5 Years Ago?
Yes you will need secondary rhinoplasty with cartilage grafts to correction the over resection of the dorsa; hump and strut grafts to improvement the columella deformity. Best to you.
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Your rhinoplasty result concerns are as much about alar rim retraction as they are about a hanging columella. To get an optimal result you will likely require columellar correction and alar rim grafts as a combined corrective procedure.
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Based on your photos it appears that you would be a good candidate for rhinoplasty, such as the example in the link below