Post-rhinoplasty: columella hanging too low? (Photo)

Question

Pre-op, I had a bulbous, droopy tip. I'm 3 months post, and my tip/columella are still very hard (as expected); I believe a graft was used to keep the tip suspended. However, since the stiffness in my nostrils has resolved, I notice the columella hangs very low when I smile (it doesn't do this when not smiling as pictured in pic 3). Once the swelling reduces and the tip "relaxes," will this be less noticeable? I am worried that I will have to get a 2nd surgery to fix this issue.

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for enquire.Swelling after a rhinoplasty depends of the surgery complexity.In this regard, the nasal swelling Post-op It can last from two weeks to two months.To reduce this swelling, I recommend you perform delicates daily lymphatic drainage massage therapy over the face (around the nose) avoid sun exposure, and take pain/inflamation pills, as your surgeron precribe you.Kind regards, Dr. Emmanuel Mallol Cotes.-

Parker A. Velargo, MD, FACS · Answer

Even without pre-op photos for comparison, it looks like you have a very nice outcome.  You likely have an active depressor septi muscle, which is what is pulling your caudal septum and columella down when smiling.  Sometimes this muscle can be cut during surgery.  An easier solution, rather than undergoing surgery again, is to have some Botox or Dysport injected into the muscle.  3 months is still early in the healing process, so time may help things settle out even more as well.  As always you should discuss such concerns with your surgeon.  Good luck!

Post-rhinoplasty: columella hanging too low? (Photo)

Answers (2)