Can my columella be re-centered on my lip?

I recently had a revision and the surgeon cut 3 mm from the base of my septum, cut a notch in my anterior nasal spine, and swing the septum over to make it straight under the midline. The problem is that my midline is off center so now my columella isn't centered over my philtrum. Nostrils look really bad. Question: now that my septum is shorter will it still be able to be repositioned in the center of my lip? What techniques are available?

Doctor Answers 3

Columella recentering on the lip

Hi hanginthere,If the midline is off center, a revision procedure/surgery could be performed to reposition it in the center of your lip. If the septum is a lot shorter and/or can't be adequately repositioned, you may need what is called a caudal septal extension graft using cartilage (either from your septum if it is available) or rib cartilage.It is worth visiting an experienced revision rhinoplasty specialist to discuss this in person.Good luck!Michael M. Kim, MD

Portland Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Can My Columella be Re-centered on My Lip?

If you had your revision surgery very recently you may be observing asymmetrical swelling which will resolve. The septum can be repositioned if necessary. Exactly how this is accomplished will depend on the length of your septum but hopefully there is adequate length. An examination will be necessary to evaluate why your nostrils look "really bad"

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision rhinoplasty

Of course this is a difficult question to answer without the aid of a photo and exam.  I actually saw a patient this week who has a very similar problem but needs additional work.  Yes you can change the position.  There are different options but all are related to your exam, available cartilage donor sites and previous surgery.

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