Revision Rhinoplasty: Q&A
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Should I Go for Revision Rhinoplasty Because of Hanging Columella?
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!)
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28 Doctor Answers |
Asked by
pinklady
in London
+2
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.
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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,...
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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.
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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.
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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.
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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...
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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...
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Correction of a Hanging Columella
A photo would be extremely helpful to determine what your actual issue is in regards to your nose. A hanging columella can be due to retraction of the nostrils/alar rim or a "hanging" of the columella due to a prominent nasal spine or other cartilage issues. Either way the problem is reversible but a proper evaluation and understanding of the underlying cause is essential in order to produce a proper result from revision surgery. A bulbous tip is a secondary issue that needs to be...
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Should I have Revision Rhinoplasty for a hanging columella.
A hanigng columella alone should not make the entire tip appear wide or bulbous. Pictures, of your nose would be helpful. If that's the only issue, the columella can be lifted through an isolated columella incision.
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Unhappy with tip , seek consultation
There are several issues you bring up; question of hanging columella, bulbous tip, etc. Even with photos it would be difficult to determine exactly what your needs are and your impresssions are without actually visiting with a physician. In the US free consultations are pretty common, just be sure you are dealing with a Boeard Certified Plastic Surgeon.
I hope this information has been useful to you.
Jon I Sattler, MD, Board Certified Plastic Surgeon, Glendora,...
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