Without seeing a profile
photo it is impossible to determine what can be done, and have you had a
If the columella is retracted, cartilage grafting may be reasonable, but the picture is difficult to evaluate.
Kenneth Hughes, MD
Los Angeles, CA
I need to see a full set of nasal pictures as described on my website to better understand your question and make appropriate recommendations. Thank you.
The photo does not help much. It is always better to be seen in person to understand what needs to be done or is possible.
Unfortunately, the picture you have posted is not sufficient to assess the degree of retraction you may have or the relationship of the columella to your nasal alae. If the columella is truly retracted grafting with cartilage is needed to lengthen the septum and/or resructure the cartilages of the columella. The fact that you have had rib grafting is suggestive that you don't have much cartilage left in your septum. This can be fixed, but you may need to have a third operation and more cartilage harvested for grafting.