Collumella show after rhino? (Photo)

Hello. I'm seriously concerned about the increased collumella show post op. I am 4 weeks post op with no reduction in exposure. Is it realistic to expect this to resolve? Will it look like before? I was hoping to have an improvement, but now I can only hope for it to look as it was, is that right?

Doctor Answers 6


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I am the guy who makes the bold proclamations, possibly putting myself at legal risk, giving bad news or stating opinions regarding poor judgement in surgical planning. I do this because I believe in helping people like you, who come on this site with questions and concerns.  

So far, everyone says 'talk to your doctor'.  I believe that's code for 'this isn't going to get better', or at least very low probability. You've got alar retraction as the principle cause of your columellar show, which is frequently due to over-resection of the lateral crura of the tip cartilages.  This won't 'settle' down in a few months, nor will reduction in swelling improve it's appearance.

Although you'll need time to heal, it is likely you'll want a revision rhinoplasty.  That's when you talk to your doctor. If he can't show you examples of people he's helped like you, then you need to go back on the consultation trail to shop for a revision rhinoplasty expert.

Best of luck!

This is not alar retraction

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this is most likely not alar retraction. although it is really soon following your surgery and you undoubtedly have some swelling on board, this is possibly due to a columellar strut (cartilage graft) that is sitting a bit too low.

Columella show after Rhinoplasty

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Dear chickchick123, I wish I could give you more information rather then the standard "it's to soon to judge after your rhinoplasty" however at this early stage you really are going to have to give more time for your recovery. It is very important that you discuss with your surgeon your concerns as he/she knows best what techniques were used and what your proposed results were. If indeed this does not improve itself with time then find comfort in the fact that this can be corrected with revision surgery. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 212 reviews

Columellar show after rhinoplasty

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Dear Chickchick123,

  • 4 weeks is still relatively early to know with 100% certainty (there could be swelling in the columella)
  • I would bring these concerns up with your surgeon who knows exactly what they did
  • Increased columellar show can occur for a number of reasons depending on the techniques used
  • It is fixable if there is a long term problem, just let your surgeon know
  • If you need a second opinion, I would visit a rhinoplasty specialist in your is too early to do anything about it, maybe you can get some reassurance

Dr. Nima

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

What you are showing is alar retraction

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Alar retraction is a result of trimming of your lower lateral cartilages; trimming of this region needs to be done conservatively or not at all to avoid this deformity. Alar retraction can be corrected with an alar rim or contour graft in the office setting.

1 month post op, some advices:

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Thank you very much for enquire.
It's too early to make value judgments with 1 month after a rhinoplasty.
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.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 306 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.