Twisted columella after rhinoplasty/columella lift. Can columella be straightened non surgically? (Photo)

Question

I had a rhino in April to slim, derotate and lengthen my nasal tip, narrow my alar base and lift my hanging columella. I'm happy with the front view but the columella is clearly very twisted with uneven nostrils. I'm not too fixated on having perfectly symm nostrils but I'm very bothered by the twisted columella and I find myself only looking at people when my chins dropped. My PS says this will correct as swelling reduces, which I doubt. Is there a non surgical solution, or is surgery required?

Brent Moelleken, MD · Answer

It appears that you do have irregularities in your columellar region.You may want to express your concerns to your doctor about the appearance.It is never a bad idea to consult other doctors as well if you don't feel your concerns are being heard or treated seriously.Remember, revision surgery is typically more difficult and demands a different skill set than first time surgery.

Afshin Parhiscar, MD · Answer

Dear Tam72Looking at 3rd photograph, it appears that your entire tip is twisted and leading to the columella shift. I suspect you would need a revision of your tip if after 6-9 months it still looks twisted and that bothers you. If you feel its not noticeable, no need for surgery.

Robert S. Schmidt, MD · Answer

Thanks for your question. I see what you're talking about with the lighting coming the way it does in these photos. You're still in the early post-operative period though, and I wouldn't be thinking about any revision work just yet. If indeed it does stay like this, you'll need a cartilage graft placed in there to straighten and stabilize your columella and the base of your nose. There's not really a way to do that without surgery. Give it some time though to see if things settle out.

Michael Elam, MD (retired) · Answer

Dear tam72, Unfortunately there is no non-surgical technique to correct your current issues. You will most likely require a revision surgery to fix the asymmetry of your columella. I find it doubtful as well that this will straighten out on its own. You will need to wait an entire year from your original procedure so that all of the swelling has dissipated before you schedule a revision procedure. If you feel your concerns are being ignored by your PS then you may want to get a secondary opinion. I would suggest if you seek a secondary opinion that you request a copy of your operative report so the consulting surgeon will have a better idea of the techniques used during your primary procedure. Best regards, Michael V. Elam, M.D.

Twisted columella after rhinoplasty/columella lift. Can columella be straightened non surgically? (Photo)

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Answer: TWISTED COLUMELLA AFTER RHINOPLASTY

Answer: TWISTED COLUMELLA AFTER RHINOPLASTY

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Twisted columella after rhinoplasty/columella lift. Can columella be straightened non surgically? (Photo)

Answers (4)

Answer: TWISTED COLUMELLA AFTER RHINOPLASTY

Answer: TWISTED COLUMELLA AFTER RHINOPLASTY

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Recommended reading

Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.