Uneven Columella Post-op

I had tipoplasty 9 days ago-cast,splints,and ext. stitches removed on day 5.Shortly after, the incision line on the columella became unconnected on the l. side.I went right back in.The Dr. glued it and put steristrips on it.Today, the steristrips came off and now my columella is uneven.The top and bottom are not lined up evenly on the left side.There is a ridge where the top of the incision sticks out from the bottom. Can and how can this be fixed and should I expect the Dr. to do it free?

Doctor Answers 7

Colummellar scars after rhinoplasty heal well

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Based on your picture, I think the best intervention is time (spent doing nothing).  Almost certainly a few months of healing will see your scar fade to where it is all but imperceptible.   The only reason your incision is so noticeable is because your surgery was so recent.

The treatments you have had thus far are appropriate and likely sufficient to leave you with a  great long term outcome.  If you get 6-12 months out and the incision has not healed well, it is generally very easy to perform a revision.  This generally can be done with only local anesthesia in the office setting. Best wishes!

Roanoke Facial Plastic Surgeon

Uneven columella after rhinoplasty

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Give your nose 3-6 months to heal. Most of them time these end up resolving on their own. If it heals unevenly it is generally a minor in-office procedure to revise. I would ask your surgeon what their policy is on charging for revisions.

Gary D. Breslow, MD, FACS
Paramus Plastic Surgeon
5.0 out of 5 stars 44 reviews

Concern about icision and scar after a nose job

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Dear rhinoplasty patient,
What you describe is a minor problem that was resolved by your surgeon’s intervention. I reviewed your post rhinoplasty photo and considering what you describe, you healed well. You will not have any significant scaring.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 224 reviews

Your columella incision will continue to improve after your Rhinoplasty Surgery.

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I read your concern and reviewed your photo 9 days post-op. My hunch is that your scar will heal favorably without further intervention. Considering you had separation at the incision, the scar looks acceptable right now, and this will continue to improve.

I hope you find this helpful.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Uneven incision line on columella after rhinoplasty is "normal" 9 days postop

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Because of the "way" rhinoplasty is performed, there is always slightly more swelling on the "tip" side of the incision, (because more of the skin blood ciculation here has been "disturbed"). This is normal and usually resolves in about 6 months.

Debra Irizarry, MD
Crestone Plastic Surgeon

Columella scar

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I am sorry that you had a problem with dealyed healing on your columella.  At 9 days post-op things are quite swollen, this may get better with time. Personally, I would not revise this scar if it is a problem for at least 6 months. It will most likely improve.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Nose shape after rhinoplasty

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Hello and thanks for your question.

Most likely the shape will improve after second repair.

It is good to hear that you trust your surgeon. I would recommend following all his suggestions/recommendations.

The swelling needs to resolve and that could take a year or so...

Best wishes,

Dr Sajjadian,

Triple Board Certified Plastic Surgeon


Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 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.