Columella-How Much Does It Shrink over Time After Open Rhinoplasty? (photo)

is the columella is the last to minimize in swelling/ also the least to shrink after surgery? I told my DR. prior to surgery that I really didn't want for my columella to be visible at all if seeing from the side views, he said this would be easy to achieve. After asking a friend DR & him looking at it, he suggested I talked to my surgeon b/c in his opinion my columella would heal in a way in which from the side would appear to hang or drip, today its day 15after surgery what do you think?

Doctor Answers 10

You appear to have a nice result 15 days after Rhinoplasty Surgery.

I read your concerns and reviewed your photos:

You did not provide a pre-op profile photo for comparison. I agree you have a bit of nostril show post-op, but your result is nice. The base of your nose is certainly swollen, and the hang of your columella may improve as your swelling dissipates.

Hope this helps.


Dr. Joseph

West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

It's too soon

Your 15-day post-rhinoplasty appearance looks pretty good!

According to the photos, I think your Plastic Surgeon has done a nice job.

Don't worry about the columella appearance yet. There will be an edema (swelling) reduction during next 6 months, so there is too soon to evaluate the final columella appearance.

In my opinion it's better too have a little edema in this phase (15th postop day) rather than an excesive retrusion (excesively hidden columella).

Thank you for your interesting question. Be patient!

Enrique Etxeberria, MD
Spain Plastic Surgeon
5.0 out of 5 stars 7 reviews

Too early to judge rhinoplasty results

You are very early in the healing process and the irregularities that you are noticing are more likely due to swelling than anything else.  The columellar size is also due to swelling.  It will take you another 6 months before you can begin to judge your result.

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

Columellar show

2 weeks post surgery is still very early for you to judge the results of your surgery - be patient and follow up with your surgeon.  Swelling can make the columella hang down more.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 221 reviews

Drooping columella after rhinopasty

Looks good so far. Nice shape and proportion. Too early to be concerned about columella. Nothing to be done about it now even if it should stay the same. Would need to wait at least 3-6 months for a revision, which you probably won't need. Focus on the positives. It looks great.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews


Normally speaking it takes one full year for your nose to settle and heal after surgery.  An open approach rhinoplasty will indeed heal "top down" with the columella being the last area for the swelling to resolve.  If at a year a patient still notes a small fullness at the columella I will have them wait a further 6 - 12 months depending on their skin thickness.

Normally speaking a columella should be visible from the side.  There should be about 2 - 3 mm visible.  This is call "columellar show".

Douglas J. Kibblewhite, MD
Vancouver Facial Plastic Surgeon

Columellar show after rhinoplasty

You're quite early after surgery so the columella will likely continue to heal. The swelling after rhinoplasty takes the longest to go away in the tip area. Continue to follow up with your surgeon to make sure everything is healing normally. Once things have stabilized you can assess your columellar position most accurately.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 21 reviews

Columella-How Much Does It Shrink over Time After Open Rhinoplasty?

 You should have this discussion with the plastic and cosmetic surgeon that did your Rhinoplasty.  From the photos, IMO, you have a nice result and when the pre-op that was over-roated downward was placed into a more aesthetic position, the Columella would be nature be more visible as it should be to be aesthetically balanced.  From a profile view, the columella should have between 3-5mm's of what's called columellar show.  You 15 day pos-top photo seems to be less than 3mm.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Columella-How Much Does It Shrink over Time After Open Rhinoplasty?

I think based upon your moderately acceptable photos your friend should practice his specialty, not Plastic Surgery. In open rhinoplasty the columella area takes the longest to heal and reduce its swelling, up to 6 months or more. Be patient and allow healing time. Or better yet call your surgeon to discuss and inform you about the post operative healing time. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Columellar Show 15 Days after Rhinoplasty

You know that your nose will change because you're only 15 days post-op. If you had an open rhinoplasty sometimes swelling of the columella is a little worse. In 35 years I've never seen swelling this severe, but be patient. If it is ultimately necessary to raise the columella this is a relatively small procedure that can be done with just local anesthesia.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 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.