Clicking noise in columella when moving upper lip side to side?

Question

Hello doctors I had a rhinoplasty 2 months ago and am wondering why there is a clicking noise in my columella when I move it side to side. I should note that no columella strut was used. Kind Regards

Terence Goh, MBBS, MRCS(Ed), FAMS (Plast Surg) · Answer

Dear BradleyK7,Thank you for your question. The most common reason for the clicking noise after rhinoplasty is from  friction between the cartilage grafts and the underlying face bones, most commonly due to the columella strut rubbing against the anterior nasal spine of the upper jaw. However, if a strut was not used, then it could be from other cartilage grafts that were used or from the nasal bones, although this would be extremely rare. You should refrain from touching your nose for a while and this may get better or stop. You should also inform your rhinoplasty surgeon of this if it persists and inquire about the underlying cause. I hope this answers your question. Have a great week ahead and speedy recovery!Dr. Terence Goh
Plastic Surgeon, SingaporeMBBS (S'pore), MRCS (Edinburgh), MMed (S’pore)Fellow, Academy of Medicine, Singapore (Plastic Surgery)President, Singapore Association of Plastic Surgeons (SAPS)International Member, American Society of Plastic Surgeons (ASPS)

Rajan Uppal, MBBS, FRCS · Answer

This entirely normalMany normal people's nose clicksIt may be related to swellingContact your team for advice.

Jerold Olson, MD · Answer

Hello,
As you know this problem can certainly happen when a columellar strut graft is placed but is a bit unusual without.  I suspect the clicking is related to the inferior aspect of the septum moving against the underlying bone.  Please get back to your surgeon and hopefully they can identify the culprit.  I think there might be a relatively easy fix for this issue if it does not improve on its own.  Good Luck!

Charles W. Guy II, DO, FAOCO · Answer

If you did not have a columellar strut placed, then I am assuming that you had a septoplasty with the rhinoplasty or else they harvested cartilage from your septum.   The cartilage portion of the septum sits on a bony pedestal called the maxillary crest.  Depending on how the remaining portion of the cartilage at the posterior angle was sitting on the maxillary crest, it can shift with side to side lip movement and cause a clicking sound.  If this does not improve with time and it is too annoying for you, then a suture can be placed between the cartilage and the bony maxillary crest to prevent it from moving and clicking

Clicking noise in columella when moving upper lip side to side?

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