Should I Go for Revision Rhinoplasty Because of Hanging Columella?
- Asked by pinklady in London
- 4 years ago
I had a Rhinoplasty operation 2 years ago and was quite happy with the results at the time, but since then I have grown increasingly unhappy with the tip. I think it looks quite bulbous due to hanging columella. What is your opinion? And if necessary, how easy would it be to correct? (I can't upload my image as it's a pdf - I could email it to you if you respond? Thanks!)
Hanging columella: a good reason for revisional surgery
I just think a hanging columella is a hallmark of bad rhinoplasty. I do not like the way they look on their own and I especially do not like what they do for a person's overall look. I think they need to be fixed, but every situation is different. Send photos and operative note if you can. Every situation is different and needs to be evaluated as such.
Fixing a hanging columella through revision rhinoplasty
The columella (portion of the nose between the nostrils) can appear to be "hanging" for a multitude of reasons. It is important to address this issue with a revision rhinoplasty specialist, in order to diagnose the cause of your issue and address it appropriately. In some cases this can be as straightforward as a slight shave of the underlying medial crura of the lower lateral cartilages. More frequently, I address this issue by straightening the columella with a nice, straight piece of cartilage taken from the septum, what is called a columellar strut. In other cases, the infratip (area below the tip) is overrotated, in which case additional maneuvers or cartilage grafts to recreate a normal tip/infratip relationship may be needed. As others have mentioned, retraction of your nostrils can accentuate the problem. With photos, I would be able to analyze your situation further but hopefully this is helpful.
Hanging columella can be an unsightly deformity
See an experienced rhinoplasty surgeon in your area and have them examine your nose. If the problem is simply a hanging columella there are many procedures to improve this. However, an experienced rhinoplasty surgeon my uncover other problems that need to be addressed.
Recent Revision Rhinoplasty Reviews
Revision Rhinoplasty Photos
Hanging columella can be improved
Increase in nostril show can be the result of a hanging columella and/or alar retraction and many times a combination of both. The good news is that it can be corrected with revision surgery.
Revision rhinoplasty for nasal tip and hanging columella
In situations like this, it is best to consult with a revision specialist. Bring along your pre and post-op photos and operative reports. Hopefully, your surgeon can help visualize what is bothering you about your current nasal form (and perhaps confirm what you've said). Things are usually a bit more complicated than they seem, and an experienced surgeon can help determine what revision (if any) would be right for you.
Hope this helps.
Most swelling should subside after 12 months, therefore if you are still unhappy with the final outcome I would recommend consulting with your Board Certified Facial Plastic Surgeon to contemplate a Revision Rhinoplasty.
Fixing a hanging columella is possible
Shortening your columella can be done with incisions inside the nose. This can be as simple as shortening the septum. The solution really depends on the cause of the hanging columella, which is usually the septum. A rhinoplasty surgeon can examine the area and feel the cause of it.
Hanging Columella in Revision Rhinoplasty
A hanging columella may develop with overly aggressive rotation of the tip of the nose or with overtreatment of the tip cartilages. In terms of revision, this is technically challenging but relatively less invasive than other issues. Dealing with the tip only shortens the recovery time after the procedure. In some cases, revision for this type of issue can be performed without opening the nose. Best of luck moving forward!
First diagnose if the issue is the columella or alar retraction
The first step is to make sure if the columella is the issue, or your nostril/ala is the problem. These two structures have a ying yang relationship. Retracted alae are very common after rhinoplasty maneuvers that try and reduce bulbosity in the nasal tip. As patients heal in the tip region there ala can pull giving a flared nostril appearance.
The solution to the problem is sometimes working on both the columella and the ala. Pick a surgeon in your region that specializes in rhinoplasty for this type of revision.
Correction of the hanging columella by revision rhinoplasty
I'm going take the liberty to make a few assumptions regarding your hanging columella since there are no enclosed photos. After your primary surgery the hanging columella and nostril retraction developed over the first year. The origins of these problems are complex and located in the details of your operation and your preop photos. Generally the hanging columella can be caused by over rotation of the tip without compensating with caudal septum. It is common to have problems with the alar cartilages and nostrils when the tip is over rotated. The treatment of these interrelated problems is reduction of the caudal septum( cartilage and mucosa) with support of the ala with cartilage and mucosa. Interestingly there is a described operation invented to address this problem. It is called a "chondro(cartilage)- mucosal flap The elegance of the procedure is that it fixes the problem without harvesting cartilage from elsewhere and can leave the good parts of the rhinoplasty unchanged.
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.