3 months post op of Rhinoplasty, do I have a hanging columella and overall drooping nose? (photos)

Question

Approx 3 months post op primary rhino. Overall big improvement and I am a reasonable patient that doesn't expect perfection. However, I am slightly concerned about the overall downward appearance of the nose and the nasolabial angle. I am aware that swelling can and does take a full year to resolve. Is it reasonable to assume that my tip is not going to rotate upwards as swelling subsides? Also, one side of nose is longer than the other.

Jason Hess, MD · Answer

Sorry you are not completely satisfied with your rhinoplasty results.  I think it is reasonable to assume that if you are not happy with your results at 3 months, they are unlikely to improve much at 6 months or 1 year.  Based upon the photos provided, you do not really have a hanging columella.  Your results are more consistent with a subtle pollybeak deformity.  This is the appearance of a dorsal nasal convexity resembling a parrot's beak. It exists when a dorsal hump is located in the supratip region of the nose which then "pushes" the tip downward causing under-rotation.  This is certainly not meant in any way to insult or criticize your results.  Based upon the side view, it is certainly improved from the preoperative pictures.  Rhinoplasty is a difficult procedure.  I would advise maintaining your relationship and close follow up with your physician.  If a revision becomes necessary, hopefully he or she will be committed to meeting your goals.  Good luck!!

Ali Sajjadian, MD, FACS · Answer

Thank you for your question!

It is understandable that you are
concerned especially with the possibility of developing a supratip fullness. Changes after rhinoplasties vary with
every patient and what you are experiencing is not uncommon.

It is important to keep in mind that it
is early to pass a final judgment. Usually, a year is required before formulating how
your nose will be, but longer with a thick skin. Even then, your nose will keep
shaping itself to complement your face for better results in the years to come. However, promoting that your nasal tip will "rotate upward" is not reasonable.

My best recommendation at the moment is
to be patient, allow nature to take its course and edema subsides for better
results. There is no doubt that once the swelling resolves, more definition and
shape will be achieved and you should be happier with the results.

Also, it is important that you keep
communicating with your surgeon and work as a team together to achieve the best
results possible.If at the end of the road you remain unstratified with your final results, a revision rhinoplasty can be considered with the right surgeon.

Congratulations on your surgery and remain positive!

Ali Sajjadian, MD FACS

Toby Mayer, MD · Answer

Rhinoplasty 3 months post op with droopy tip and hanging columella will not improve much and you are right in that it will not rotate up. See your surgeon or a revision rhinoplasty specialist.

Darryl J. Blinski, MD · Answer

Best to obtain ONLY IN PERSON consults and bring your BEFORE photos to the consults.. Revision surgery after 1 year post op...

Frank Barone, MD, FACS · Answer

I do not think that you will see any upward rotation of your nasal tip as the residual swellingsubsides.  Although the tissues will soften after 3 months, the majority of edema has resolved.  In reviewing your photos, it appears that the downward turn of the tip (so called 'polybeak deformity') is primarily due to under projection and under rotation of the cartilage in the tip combined with protrusion of the columella.  It also appears that your nostril rim is somewhat retracted in the post operative photo which contributes to the appearance of the columella 'hanging' of being lower.Revisional rhinoplasty is more difficult than primary nasal surgery so I would suggest that you see a plastic surgeon that is experienced in this area.  Secondary surgery can be quite successful however and if these issues are truly bothersome to you, I think it would be worthwhile to seek consultation with an appropriate specialist.

3 months post op of Rhinoplasty, do I have a hanging columella and overall drooping nose? (photos)

Answers (7)

Answer: 3 months post op of Rhinoplasty, do I have a hanging columella and overall drooping nose

Answer: 3 months post op of Rhinoplasty, do I have a hanging columella and overall drooping nose

Answer: Drooping of nasal tip post rhinoplasty

Answer: Drooping of nasal tip post rhinoplasty

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3 months post op of Rhinoplasty, do I have a hanging columella and overall drooping nose? (photos)

Answers (7)

Answer: 3 months post op of Rhinoplasty, do I have a hanging columella and overall drooping nose

Answer: 3 months post op of Rhinoplasty, do I have a hanging columella and overall drooping nose

Answer: Drooping of nasal tip post rhinoplasty

Answer: Drooping of nasal tip post rhinoplasty

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.