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Hanging Columella Swelling 4 Months After Open Rhinoplasty, Is This Likely to Change?

Hi there, I had an open rhinoplasty(correction of all bony and cartliaginous elements) and septoplasty (deviated septum and turbinate reduction) done 4 months ago. My tip and columella look big. I was really happy when I saw my nose after the cast was taken off, but now I'm a bit worried. My columella looked ok first week after the surgery but now it appears to be hanging.I am really concerned about this and would appreciate if you could advise me on my concern.

Doctor Answers (4)

Hanging

+3

When an open rhinoplasty is done the incision is near the base of the columella> this effectively traps the normal lymph flow, the subsequent swelling will cause the hanging columella effect. Wait at least two more months and then judge.


Los Angeles Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Hanging columella after open rhinoplasty

+2

Your columellar show can certainly change as healing continues.  Healing takes longer in a open rhinoplasty and does not occur at the same speed through out the nose.  Edema can certainly be the main issue for the present appearance.  Be patient.  Sometimes unexpected scar tissue prevents the natural shrinkage of different areas of the nose after open rhinoplasty but scar tissue can be easily corrected.  Your surgeon will know when and if you might need a little touch up.  Best wishes.

Louise Ferland, MD
Richmond Plastic Surgeon
4.5 out of 5 stars 7 reviews

Your hanging columella may be due to nostril retraction 4 months after Rhinoplasty Surgery.

+1

Thank you so much for sharing your photos. Your increased nostril-show is impressive 4 months post-op. Your hanging columella appears to be multifactorial: You can see nostril retraction along with an exaggerated curvature of your columella that is leading to your excessive nostril-show on profile.

Before considering further surgery, you could be evaluated for a possible injectable filler treatment to your nostril margins to try to lower these. You should consult a surgeon experienced in the delicate art of using fillers in your nose. I prefer to use Silikon-1000, an off-label filler for permanent results.

You may ultimately require revision surgery to straighten your curved columella, but this should be left as a last resort.

I hope this is helpful for you.

Regards from NJ.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 285 reviews

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Hanging columella after surgery

+1

After 4 months I do not think that your columella is going to rise, sorry to say. The rest of your nose looks great so maybe it wasn't apparent at the time of the surgery, or maybe a suture broke. In any case if it remains like that a revision to lift it should be pretty easy. Just diiscuss it calmly at your next visit with your surgeon. He/she will want you to be happy and I suspect will help you. Be prepared to wait until 6-12 months after surgery before doing any further touch up. Often it is not a good idea to go back too soon as there is still too much healing and swellin to be acurate. Good luck.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 29 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.