7 months post rhinoplasty - does it look like my hanging columella was addressed? (photos)

Question

I’m 7 months PO from a primary rhinoplasty and my main area of concern was my nostrils. I wanted my hanging columella and nostril show reduced but as time goes on I feel like my dr didn’t address these issues. Could I have some feedback please? My septum also shows more on one side from a below view and this wasn’t previously an issue - why has this happened?

Tanveer Janjua, MD · Answer

You have a mild combination of both. BTW, nose looks great, so the surgeon did a good job. 
The columellar or nostril show is not bad as it is not taking away from the beauty of the nose. However, if it still bothers you a conservative columellar pull back (reduction) is an easy procedure done under local anesthesia. 
Regards
Dr. J

Eric M. Joseph, MD · Answer

I believe that your long and deviated nasal septum may be the cause of nostril asymmetry on both sides. Generally, an issue like this may require revision rhinoplasty surgery. If you do not have complete trust in your surgeon, please consider getting a second opinion. Thank you for your question. Sincerely, Dr Joseph

Ronald J. Edelson, MD · Answer

You do have a hanging columella. Oddly a hanging columella is one of the easiest thing to avoid and treat but is also one of the most common complaints after rhinoplasty. It’s easy to correct with a closed approach simply by shortening  the lower edge of the septal cartilage . No cartilage graft is needed

Thomas Spalla, MD · Answer

What has likely occurred is that the increased tip rotation (upwards) which has improved your nasolabial angle has led to the increased columellar show. The nose continues to evolve for a year, and beyond, after a rhinoplasty, so there may be some additional changes which can occur.
If this fails to improve, or worsens, at about a year after surgery, you could consider a revision to the tip.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, unfortunately you appear to have a significant amount of alar retraction. Although it is normal to still be swollen at seven months, this will likely not get better and will only worsen with time. I think a revision would be very beneficial for you in order to correct alar retraction, slightly elevate your tip, refine the tip, perform nasal Tip Deprojection, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

7 months post rhinoplasty - does it look like my hanging columella was addressed? (photos)

Answers (6)