Safe to Have Another Surgery to Repair Columella and Get Nasal Arch Back?

i have just undergone a revision rhinoplasty about 3months now due to upturned nose & hanging columella. cartillages were taken from my ear to lengthen and cushion the tip of my nose & for columellar support.

Problem is, i dont like my front & sideview. my nose is still upturned and the columella is long and straight which looks like a letter "I". my nostrils very visible even if i'm not tilting my face. the insides between my nostrils very noticeable too. i'm so self-conscious now than before...

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arch columella nostrils upturned female long safety self-esteem

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7 Doctor Answers | Asked by oriental girl in asia

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Short, up-rotated nose following revision rhinoplasty.

If rhinoplasty is the most difficult facial plastic surgery procedure, then elongating the over-resected nose is the most challenging rhinoplasty. Unfortunately, I think that your case bears this out and although further surgery can result in improvement, it will be very challenging and you will need to seek out a highly experienced revision rhinoplasty surgeon. The decision to proceed with another surgery will not be any easy one and should not be considered until 1 year... more

Lengthening the nose in revision rhinoplasty often requires rib cartilage

Hello and thanks for the question. I agree with your assessment of your nose after your revision rhinoplasty. Your nasal tip needs to be counter-rotated or brought down so that your nostrils are not so visible on front view. Your infratip (the area of the nose below the tip) needs to be lengthened as well. Obviously examining you in person would be ideal but based on your photos, I believe you would need extended spreader grafts to push the tip down and forward and possibly a... more

Too short noses can be improved by raising the bridge and lowering the nostrils

When the dorsum is lowered and the tip cartilages are reduced, the nose shortens. The same principle also works in reverse. If your bridge is raised so it is straight, your nose will lengthen. If a surgeon takes a "composite" graft of cartilage and skin from one of your ears (if there is any cartilage left) and puts the grafts inside your nostrils, the nostril edges will come down. This technique is very reliable, and many patients is your situation need... more

Revision rhinoplasty to improve columella and shortened nose

Revision surgery is a possibility but I would allow your nose to heal further first. Waiting about a year for your nose to stabilize would allow for a better assessment of what changes need to made. It also allows the nasal tissue plans to soften as the scar matures in the area.

Hanging columella and alar notching

You can safely get correction/improvement of these , but as stated by other wait close to a year before seeking revision.

Sam Naficy, MD

80 reviews

Seattle Facial Plastic Surgeon

www.seattleface.com

Short upturned nose after Rhinoplasty

Yes, from your photos the nose is upturned, with a scooped bridge, upturned (shortened) nose and hanging columella. This is a tough nose to revise with Rhinoplasty but it can be done. You need a columellar tuck as part of any future Revision Rhinoplasty IMHO.

Short Nose and Hangng Columella 3 Months after Revision Rhinoplasty

At 3 months it appears your nose does need to be lengthened, but the hanging columella may improve as swelling resolves. It is best to wait another 9-12 monjths before considering another revision.