Does the columella tend to drop similar to the nose tip dropping during healing post rhinoplasty?

Question

Just to get a general idea on the procedure, will the Dr need to take into consideration the dropping of the nose tip and columella when performing rhinoplasty? For example, we know the nose tip tends to drop due to gravity during healing stages, does the columella also tend to drop? Or, let's say it appears retracted fresh out of cast removal, is this placement of the columella often seen as the final result? Will it worsen as the nose tip drops, or drop along with, looking less retracted ?

Ronald J. Edelson, MD · Answer

Wow. I couldn’t have said it better myself. If a long nose is shortened it does tend to drop  back down during the months after rhinoplasty. Unfortunately many surgeons don’t do anything to shorten the nose which is why many rhinoplasties look too long afterwards. Or they have what is called a hanging columella. If a nose is very long I take steps to overcorrect the long nose because I know it will drop down

Suleyman Tas, MD, FEBOPRAS · Answer

Dear Bambi'sBusiness,

Thankyou for your question! To answer your question, it really depends on the technique used in your surgery, the columella appearance may also change due to gravity effects. Although, this is a normal appearance for the columella and the tip to be higher but after cast removal procedure which settles by time. I am attaching a link for before and after if you would like to look deeper into the procedure and what to expect.

Regards,
TAS TEAM

Thomas Spalla, MD · Answer

When performing a rhinoplasty, the surgeon does take into account the current and future change of the nasal tip. As you correctly noted, the nasal tip does tend to droop with aging. Therefore, measures to stabilize this are performed to counteract this. The columella doesn't tend to sag independently of the nasal tip.

Zoran Potparic, MD · Answer

Columella may have different presentation before rhinoplasty and that should be corrected with rhinoplasty. Usually elevation and rotation of tip would streighten columella; retracted columella may need different approach. These are issues that you need to discuss with your surgeon ahead of surgery based on your own situation. Hope this helps. Good luck.

Robert Ciardullo, MD · Answer

Does the Columella drop along with the tip postop? good question. It is variable. in some cases particularly if the pre-operative columella was a “hanging columella“ it may tend to drop overtime in the postoperative period compared to the early appearance when the cast was first removed. However if a patient had a retruded columella preoperatively or a tendency toward that, it will probably keep that appearance Postop and may even look more retruded if the tip drops without the Columella dropping. A lot depends on the preoperative condition and also what means of support was given to the tip and columella at surgery.

Does the columella tend to drop similar to the nose tip dropping during healing post rhinoplasty?

Answers (5)