Crooked columella, uneven nostrils 12wks post rhino/septo w/ tip graft & nasal base reduction. Swelling or need revision?(photo)

Question

I had surgery 12 weeks ago and my columella appears crooked. On the left I have a bump, or "step up" in columella, which makes my nostrils appear uneven. The left side of columella also slightly hangs more than on the right. This area really shows no improvement since surgery, even though swelling in the rest of the nose has lessened significantly. Does this appear to be swelling? Will it straighten and even out or does it look like I may need a revision to this area in the future? Thank you!!

Ali Sajjadian, MD, FACS · Answer

Eaz81,I do see the concerns which you are mentioning. However, 12 weeks post op is still early and there is still a significant amount of swelling in the area. Healing time for a rhinoplasty ranges up to 1 year, meaning the swelling in your nose will not completely subside for another 7 months. I recommend being patient until this time, and if you still feel as though the problem persists speak to your plastic surgeon for possible revision.Hope this helps!Dr. Ali Sajjadian

Todd Christopher Hobgood, MD · Answer

Great question and thanks for sharing your photos.The first most important message is to stay in close contact with your doctor.  He or she can really be your best source for information and probably knows your anatomy better than anyone at this point.Next, I do think this is very early in your course to be too concerned.  I agree- give it time.  Massage may be helpful.  Time will probably be even more important.  Try to relax.Having said this, it does appear that the end of the septum has shifted moving the footplates out into the nostril.  Essentially, the base of the septum may have shifted slightly to the side moving the footplates of the medial cartilage into the nostril.  Hopefully this is just swelling and things will relax.I generally will not operate on a nose for one year after surgery.  It places the patient in the best shape for a great outcome.  Try to get a hold of your operative notes and any drawings or schematics from your surgery.  A very important consideration in the future if you do require additional surgeries will relate to the availability of additional septum for harvest that will be needed.Best of luck in your recovery.Dr. Hobgood

Bryan Friedman, DO · Answer

12 weeks is still way too early before any consideration be given to a revision rhinoplasty.  From the looks of the picture, it is the medial crural footplates, or portions of the lower lateral cartilage that are causing the asymmetry.  Allow for swelling resolution and at one year's time reassess.

Garrett H. Bennett, MD · Answer

Swelling after surgery can be variable as you have described. Tell your surgeon your concerns and he may be able to place steroids to help speed recovery. Probably after that you just need to be patient for at least a few months more.

Crooked columella, uneven nostrils 12wks post rhino/septo w/ tip graft & nasal base reduction. Swelling or need revision?(photo)

Answers (4)

Answer: Recovery after surgery

Answer: Recovery after surgery

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Everything you need to know about Rhinoplasty

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Crooked columella, uneven nostrils 12wks post rhino/septo w/ tip graft & nasal base reduction. Swelling or need revision?(photo)

Answers (4)

Answer: Recovery after surgery

Answer: Recovery after surgery

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.