Will Columella Fullness Subside with Time?

Question

I had an open Rhinoplasty about 5 months ago. The overall look of my nose is okay except for the tip/columella area. I think my columella looks too wide and my tip a little round. My doctor refined my tip with sutures and added a graft for support in my columella. Is this attributing to my columella looking wider/fuller than before, and will it subside and shrink with time? I'm hoping my nose will soften up and get smaller in size. Any feedback or advice would be lovely.

Thomas A. Lamperti, MD · Answer

The fullness you are experiencing should improve with time. The tip/columella is the last area for the post-operative tissue swelling to resolve. It can take up to about a year to see the swelling return to normal.

	Check with your surgeon to check to make sure everything is healing as anticipated otherwise.

Brent Moelleken, MD · Answer

It is usually best to wait between six months and a year before contemplating any revisions.

	Revisions in this area are usually straightforward.

	Patients must always be realistic, particularly with tip fullness and the overall size of the nose.  Noses that were once very large will not usually look good if they are made excessively small.

Ricardo A. Meade, MD · Answer

It's a bit early to discern swelling from the final result at this point but you may be needing that to be looked at.  Revisions aren't done until a full year afterwards typically.
The incidence is about 6%. Be patient, the need for a revision will be determined by your level of dissatisfaction as well as the result.

Toby Mayer, MD · Answer

Columellar strut and tip swelling is frequently seen and may take 1 year to resolve. If at that time it is still present your surgeon can do a minor procedure to improve this.

Barry L. Eppley, MD, DMD · Answer

Fullness in the columella after rhinoplasty at 6 months after surgery can be a contributing factor. A columellar strut is placed between the medial footplates which make up some of the columellar width. This can increase its width by 1 or 2mms dependent upon the width of the graft. That combined with persistent swelling will definitely make the columella appear slightly wider. Despite the widespread use of columellar struts, increased columellar width is not reported as being a significant problem with its use. I would wait a full year after surgery so that every little bit of swelling is gone before making a final judgment.

Andrew Pichler, MD · Answer

5 months after rhinoplasty the swelling of the columella should have subsided almost completely. Tip graft, columella graft may contribute to the residual swelling and may not resolve. Correction is possible but you should carefully consider this.

Catherine Huang-Begovic, MD, FACS · Answer

It's hard to know how much thinner your columella will get - it depends on how thick a piece of cartilage your surgeon used.  However, I'd wait until about a year after your surgery before proceeding with revision surgery.  I'd continue to see your surgeon, have him document changes with photos, and if you are still unhappy after a year, I'm sure he/she would be happy to revise it for you.

	Dr. Cat Begovic M.D.

Steven Wallach, MD · Answer

Sometimes a columella strut can contribute to the columella width and certainly swelling can as well.

Michel Siegel, MD · Answer

Teresa:

	The tip will most likely come down with time as the swelling continues to improve. As for the width of the columella, it will depend on how wide the graft is. At 5 months you still have some time to go before your final results are evident.

	 

	Michel Siegel, MD

	Houston, TX

Darryl J. Blinski, MD · Answer

This is one of the draw backs to "open rhinoplasty". The extended swelling in the columella, up to a year or more. Be patient, from MIAMI DR. Darryl J. Blinski

Will Columella Fullness Subside with Time?

Answers (16)

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