Will Columella Stiffness Resolve After Rhinoplasty?

Be patient. It takes months to years for grafts to soften. Please don't expect things to return exactly the same as before, afterall, the grafts were placed to add structure and support (remember, this is a good thing).

The tip will be stiff for a while due to the skin swelling, but the columellar strut can also create some stiffness. This should settle out with time but may take a year or so after surgery. The strut is there to help prevent excessive loss of of tip support after surgery.


 

Nasal tip stiffness will improve but likely not completely resolve following rhinoplasty. Your Facial Plastic Surgeon will often place a robust columella strut to prevent drooping of the tip following surgery. This cartilage survives for the long-term and can result in a tip that is stronger and more rigid than before surgery. Ths can be compounded by the numbness that patients experience following external rhinoplasty which can last up to 12 months.Stephen Weber MD, FACS

It is not unusual to have a stiff nasal tip and columella 6 months after rhinoplasty. Placement of columella strut enhances postoperative swelling and may prolong firmness in the area. While the upper nose skin can be soft and mobile in a few months, it can take a year or two for the skin to get to its ultimate softness in the lower part of the nose.

This is different than a palpable strut. If you are feeling the strut, this will not improve without surgery. Be certain to check in with you surgeon if you have any concerns. They will be able to answer more thoroughly.

It depends on how it was done as to how fast it will soften. if it does not change in afew months you should see an experienced revision rhinoplasty surgeon:

Sometimes it can take up to a year or longer for the tip to soften up and feel normal again especially if you have thick skin. I would continue to be patient for now.

In general, almost all noses are numb right after a rhinoplasty. In most cases its the tip that is numb, but this numbness can extend down to the upper lip, and in rare cases some of the teeth. There are nerves that are cut and stretched during a rhinoplasty, and it takes a long time for those nerves to start working again. This is true of an open as well as closed rhinoplasty, although it tends to be more extensive in open rhinoplasty. This could also be more extensive if a septoplasty is performed at the same time. A revision rhinoplasty is a much harder surgery with a lot of internal scarring to cut through. This can also be a reason for prolonged numbness. This, along with the swelling, gives you a stiff, plastic type feel, and can give you an odd smile. However, the nerves will start working and again, and your nose stiffness will go away with time. As the nerves grow back, you may feel some tingling, itchiness and on occasion pain. This takes in most cases months, but can take years in rare cases. Extremely rarely, the numbness is permanent, although I have never seen such as case.Best Wishes,Pablo Prichard, MD

Swelling after an open rhinoplasty can take a year or even longer to completely resolve. What you describe could certainly be swelling or may be the columellar strut. For now, I would agree that waiting is a good option and see how things turn out at about a year after surgery.

It's really hard to predict when the swelling will go down.  However, i'd give it some time.  The function of the strut is to make the tip more stiff - so if it was a thick piece, it will probably not get much softer.  Only your surgeon knows what he did specifically in your surgery.  I'd recommend keeping in close contact with him/her so you can get all your questions and concerns answered.

Dr. Cat Begovic M.D.

Hi SandraB,

The nose typically feels stiff or firm after rhinoplasty surgery, mostly from swelling. Patients who have an open rhinoplasty with an incision in the columella (skin between the nostrils) generally have more stiffness as compared to patients who have closed or endonasal rhinoplasty. Other factors that contribute to nasal tissue stiffness include cartilage grafts and type of cartilage. Rib cartilage used in rhinoplasty is obvious by the way the nose feels, as it's generally much stiffer. 

Most stiffness after rhinoplasty will gradually resolve & soften over time. Approximately 80% of the swelling resolves with a couple months. However, the remaining swelling takes at least one year, if not longer, to resolve. Speak with your rhinoplasty surgeon regarding any concerns you have. Only after a comprehensive evaluation can a surgeon help determine appropriate options for you. Best of luck.

Dr. Chaboki