Can Columellar Retraction Be Fixed? What About The Thinning Of The Area? (photo)

Repairing columellar retraction requires strong, stable grafting material.  If your septal cartilage is depleted from prior surgery, rib cartilage is the best option.  There is no absolute age cutoff for harvesting and using rib cartilage.  In general, rib cartilage becomes more calcified with age, but the amount of calcification varies widely from person to person.  Use of prior irradiated cadaver cartilage does not prevent the use of your own rib cartilage.  In general, vascular compromise of the columella is only a concern in patients with multiple previous surgeries.

Hi, friend.

I take it that the upper part ( closest to the tip) of the columella is showing the most retraction ? And, is it your view that it makes your nose look " too short?"

You know, you might just want to consider trying a filler. A short term filler like Restylane or Juvederm will give you  the equivalent of tissue replacement without surgery. You could even try an injection with sterile salt water--first -- to see if the tissue will expand and look better. No risk there.

Science is now delivering a large roster of fillers, some long-lasting and some, even permanent. That's good news for patients.

Always consider non-surgical techniques rather than surgery, if appropriate. In your case, particularly, check that out.

- Robert Kotler,MD, FACS

  Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON

Yes, the retracted Columella can be plumped out using an ear cartilage graft.  The indented lower section of the Columella can also be filled out using similar cartilage taken from behind one of th ears....hopefully, you still have some of this cartilage left after your Open Rhinoplasty.

The columellar retraction appears to be just cosmetic, not structural, and therefore you don't need strong cartilage taken from your ribs to support the tip. Ear cartilage is much easier to harvest and will provide the improved contour you desire. The thin feeling you describe is secondary to the retraction; blood supply should not be a problem.