What Can I Do About a Badly Aligned Stitching on Columnella After Open Rhinoplasty?

It's been almost a week since my open rhinoplasty procedure and while I'm happy with most of it so far I've noticed that my stitching seems unusual-it is loose, with individually tied stitches, and the main part of the columnella seems to have been stitched in place almost OVER the base rather than the two sitting aligned. Could this simply be that the top is more swollen than the base and therefore jutting out more? Is this normal and will it heal well, and if not what can be done about it?

Doctor Answers 5

Concern about scar on columella at one week postoperatively from open rhinoplasty

Only one week after an open rhinoplasty is far to early to judge the ultimate outcome of the incision. Much of what your are seeing is due to the considerable amount of swelling present on the columella.

Be patient! It can take up to a year for the swelling to maximally resolve. At that time, you will be able to judge the result with great precision. It is very rare that these types of incisions need scar revision.

Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews


Clean that wound and it will heal faster and better. Very few open tip incisions need revising and yours looks fine. Swelling always happens at first

David A. Bray, Sr., MD
Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

The skin above your columella-scar will be more swollen than the skin below the scar following Rhinoplasty Surgery.

I read your concern and reviewed your photo. What you're describing is difficult to see in the photo of your nose. In general, the skin of your columella that is attached to your tip skin will be slightly more swollen than the skin attached to the base of your nose. Columella scars heal without incident in the vast majority of cases. You should certainly address your concerns with your surgeon, but your scar should not be problematic for you in the long term.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Columellar scar after rhinoplasty

It's difficult to see from your photo the stitching problem you describe.  However, before you worry about the incision, I'd give it some time.  1 week after surgery is still too soon to see how the incision will look.  This incision usually heals beautifully and is usually barely perceptible.  The individually tied stitches are common and the looseness allows the skin to swell under the sutures since the skin swells after surgery.

Since you're approaching a week, you probably have a post-op visit scheduled soon.  I would address your concerns with your plastic surgeon.  I'm sure he or she would be happy to take a look and let you know if everything is going ok.

Dr. Cat Begovic M.D.

Catherine Huang-Begovic, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 32 reviews

Columellar Stitching after Open Rhinoplasty

The columellar flap - the portion of skin above the incision line will typically be more swollen than that skin below the incision. Additionally, if cartilage grafts have been placed it my create more volume in this area as well. Ask you surgeon about what your concerns are. Remember that is takes months to see the final result after nasal surgery. Your patience will most likely be rewarded with a nice result. Best of Luck  Dr Harrell

Jon F. Harrell, DO, FACS
Miami Plastic Surgeon
4.9 out of 5 stars 49 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.