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Will Columella Drop in Place After Rhinoplasty?

I had a Rhinoplasty with my deviated septum fixed, bridge narrowed down and nose tip lifted. When my cast was removed my nose appeared somewhat straight but the surgeon gave me an exercise to try and push one side in. My columella was tucked under and felt tight. My surgeon said that he did this on purpose and it would drop. The columella has not dropped and now my nose looks like it is drooping to the L side including the columella/tip and the bridge. My doctor said to push the cartilage to the side with my finger daily. Will this really work?

 

Doctor Answers (5)

The nose takes alot of time to settle after surgery.

+1

Without knowing the timing of your surgery and techniques utilized, I can generally tell you that the nose will settle and the columella may likely become less elevated with time as the scar tissue softens as stitches absorb. Give it at least 6 months and preferable 1-2 years before making any final judgements.


Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Rhinoplasty and columella

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 Nasal exercises are not something that I find very common. Without seeing your photos or examining you in person, I could not give you any suggestions other than to stick with your doctor during the post-op period.  If you are not happy you can always get it revised down the road.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Post operative nasal exercises

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It is very hard to determine specific issues related to another surgeon's work, especially without photos from before and after and an operative report. One question I would ask is if this a new deviation or a partially corrected/uncorrected persistent one? While I do not recommend pushing the nose as you describe, you should follow the advice of the surgeon that perfomed the work. Perhaps there is some technique he or she used that I am not familiar with...

In many instances, a suture will be placed from the bottom of the septum to the columella. This suture is typically a dissolving one. Depending on what suture was placed, it may take as much as 3-4 weeks to go away. Also, the incision at the bottom of the septum tends to make the area stiff for a while after surgery. Other possibilites are that the tip was sewn to the septum to help change its position. Finally, if an open approach was used, the columellar incision may take a while to soften. Fortunately, the issue you describe does usually correct over time.

Try not to worry and listen to your surgeon's advice. He or she knows best how to take care of you in the early post operative period. If problems persist down the line, there are always options for repair.

Best of luck.

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

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Columellar Position

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You do not mention when your surgery was done. Remember that appearance will change as swelling resolves.

I don't advocate post operative massage, but work in concert with the surgeon who did your work . It sounds like it is much too soon to start second-guessing your physician. If you're ultimately not satisfied, you will have multiple alternatives.

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Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Hard to tell without a picture

+1

I would need to see your nose to help answer your question. However, I doubt that exercises will help to change the configuration. It may get better in time depending on how far out from surgery you are. In the end it may need a 'touch up' to get it right.

G. Gregory Gallico III, MD
Boston Plastic Surgeon
3.5 out of 5 stars 3 reviews

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.