Do I have alar retraction, columella hanging or combination of both? (photos)

Question

I want a revision rhinoplasty. What can be done to corrected my upturned tip. Do I have alar retraction, columella hanging or combination of both?

William Portuese, MD · Answer

It appears that you have both a hanging columella and alar retraction. The hanging columella is much more prominent than the alar retraction. Alar Retraction is  treated with composite skin grafts harvested from the ear, while a columella-plasty is required to de-rotate the tip of the nose and remove excess cartilage and skin that's hanging down. Choose your second surgeon very wisely based on extensive experience.

Toby Mayer, MD · Answer

Alar retraction and hanging columella after rhinoplasty. Unfortunately you have both! You will need revision with alar composite grafts and a septal extension graft,etc. See several VERY EXPERIENCED  revision rhinoplasty specialists and they should be able to show you many results of revisions in noses like yours and worse!

Suleyman Tas, MD, FEBOPRAS · Answer

Hi,
After revision Rhinoplasty you can have your better look,
and yes you have combination of both, 
Regards

Bradford A. Bader, MD · Answer

You appear to have both a hanging columella and alar retraction. This is caused by an over-shortened and rotated nose with a prominent infratip lobule. Revision surgery should be focused on lengthening and de-rotating the nose with a septal extension graft and reducing the alar retraction with articulated alar rim grafts along. Please see a very experienced revision rhinoplasty expert as this can be a difficult problem to fix.

Richard W. Fleming, MD (retired) · Answer

You have both alar retraction and a hanging columella with a short nose. Based solely on these pictures I recommend you consider lifting the columella, placement of a septal extension graft to lengthen the nose, and possibly an alar rim graft of cartilage to improve the contour of the nostril rim. See an experienced revision specialist.

Do I have alar retraction, columella hanging or combination of both? (photos)

Answers (5)

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