Is there a way to lengthen the columella?

I had a rhinoplasty 6 months ago. My doctor deprojected my nose and also shortened my columella. Now my nose looks smashed down to my face and my nostrils are wide and in a permanent flared position. My original nose was very nicely narrow and upturned. I thought he was just going to deproject my tip cartilages a bit, not cut out a section of my columella and pin it down to my face without regard of the flared nostril position. Is there a technique to fix this?

Doctor Answers 3

Revision rhinoplasty is in order, but perhaps there is the non-surgical revision rhinoplasty option.

Dear Kiwibird000;

At six months, now is the time to think about revision. Whether or not you would require surgery -- and what kind of surgery -- depends on a surgical consultation of course. The most important thing is that with the points of dissatisfaction that you have improvement. Generally, improvement is impossible. It is hard to tell exactly what is appropriate because it depends on:

  •     Thickness of the skin
  •     Presence of scar tissue
  •     Strength of the cartilage

But a consultation with a rhinoplasty super-specialist – one who performs nearly only rhinoplasty – should give you important answers. You need to do some homework, too.

The advantages of the non-surgical techniques are obvious.They are:

  •    Economical
  •    Less time-consuming
  •    Often give a more precise result

But all of the above assumes the procedures would “work” and may be appropriate for your case.

Non-surgical rhinoplasty works because tiny drops of Silikon 1000 are injected just under the nasal skin. Over time, the body walls off those drops with new tissue which provides the plumping action to fill in divots or marks in the nose. The same effect can happen with plain salt water to provide a preview how the nose will look after treatment. The Kotler Saline Demo lasts perhaps two hours, but long enough to take a photo of what the finished nose will look like.

One area where injection revision rhinoplasty works very well is in equalizing asymmetrical nostrils and making them look more natural.

I hope this information is helpful to you.Do a lot of homework and you will be a leg up on the situation.

Best wishes,

Robert Kotler, MD, FACS

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 85 reviews

Increasing tip projection

If your nose appears disproportionate and you lack tip projection then this can be corrected with a columellar strut graft.  Ask your plastic surgeon about a revision or get a second opinion.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

May need a columella strut graft

A columellar strut graft may provide more nasal tip projection and in doing so more columella length.  There are cases where the actual columella needs additional soft tissue and this can be addressed via several methods.  A well trained and experienced plastic surgeon could help you determine what is needed and best way to go about achieving the result that you want.

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 162 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.