Retracted columella after revision rhinoplasty - would steroid injections be effective? (Photos)

Question

I’m feeling quite distressed because I developed a retracted columella after my rhinoplasty, and it’s really affecting the overall balance of my facial features. I’m hoping to find a solution, possibly through columella reconstruction, but I’m finding it difficult to identify a highly qualified surgeon here in Europe. I was also advised to consider steroid injections in the columella area, but I’m unsure whether this is appropriate or effective in my case. Any advice would be greatly appreciated. Thank you

Kyle Kimura, MD · Answer

Thank you for your question and photos. 
In general I would not recommend steroids to this area as that would potentially make the columellar retraction worse. I would consider whether a smaller procedure to place some type of columellar strut (likely from ear cartilage) would help fill this area to prevent the retraction. The last photo you uploaded looks to show some type of dorsal irregularity and I cannot tell from the photo alone if this is from bone, cartilage, or scar tissue. If scar tissue, this can sometimes benefit from steroid injections to flatten the area, but if cartilage or bone, may need a revision procedure if this is quite bothersome.
Hope this helps and best of luck! Kyle Kimura, MD

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty to correct the columellar retraction. A surgeon can accomplish this by placing a columellar onlay graft, among other maneuvers. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Retracted columella after revision rhinoplasty - would steroid injections be effective? (Photos)

Answers (2)

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