Hello My columella has retracted. I asked before and ws told my own rib cartilage could be used which is great. I have seen some great dcotors who can fix it But since the previous surgeons used irridiated cartilage , I was first told at 38 I was too old for my own rib? now I find out at 49 they can still use my rib. My Question- can Blood supply and vascular lining also be fixed or is the feeling of being thin the result of the retraction? thank you . i would like to have this fixed
Can Columellar Retraction Be Fixed? What About The Thinning Of The Area? (photo)
Doctor Answers 4
Can Columellar Retraction Be Fixed? What About The Thinning Of The Area?
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.
Options to Correct Columellar Retraction
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.
Columellar retraction can be repaired
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.
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You Might Consider a Filler Rather than Revision Rhinoplasty with Grafting
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
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.