Does my columella look normal 35 days post-op? (Photos)

After my cast was removed post rhinoplasty I was shocked to see my columella sewn on bent, but my Dr assured me it was normal and said that no nose is perfect and no one will even notice it. He explained after one further week it will have healed nicely and would no longer show. So... just over 3 weeks have passed since then, so it has been over 1 month post op. I have no idea what is normal at this stage in recovery but to put my mind at ease I wanted to get some other opinions.... Many thanks.

Doctor Answers 8

Reality check.

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Your columella is not normal. It is not nearly normal.

All due respect, I don't think you can have your primary surgeon revise your columella. If he thinks this is normal, I wouldn't trust him to operate on it again. Absolutely not.

The good news is that, in skilled careful hands, it can probably be improved rather substantially, without harming the rest of your nose.

Omaha Facial Plastic Surgeon
4.8 out of 5 stars 42 reviews

Some comments

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There seems to exist 2 separate problems there:
-the closure of the columella is not accurate, there seems to be a step and a displaced closure, and this is difficult to understand because the overal result of your nose is quite good, so your surgeon is supposed to know how to close a columella, maybe an assistant or trainee did the closure?
-something is sticking out or bending or protruding there, did you get any septoplasty, septal lengthening or tip grafting there?

Give it time, no less than 6-8 months, if persistant I am sure your surgeon will correct this free of cost, it is a major defect spoiling an, otherwise, brilliant result.

I recommend you manage this delicate and embarrasing matter with highest and best polite manner with your doctor, he'll be understanding for sure.

Alejandro Nogueira, MD
Spain Plastic Surgeon

Twisted columella after open rhinoplasty

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I'd agree with most of the other docs here--your columella isn't supposed to look like that. Don't let anybody do anything until at least six months pass though. It doesn't look like it's a problem of the skin incision alone; it seems that the lower septum is twisted and might need further manipulation.

Malik Kutty, MD
Sugar Land Plastic Surgeon

Crooked columella after open rhinoplasty

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Your columella appears to have been sewn a bit off... You will likely need a revision for that in the future.

Jeremy B. White, MD
Miami Plastic Surgeon

Does my columella look normal?

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Thank you for your question.

It would be best to speak to your surgeon and organise a meeting. I suspect a revision might be needed at some point in the future.

kind regards 

Crooked Columella not quite Right

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 While you can account for some swelling and some deflection, your columellar does not look right. You do have some excess swelling and there is some overlap of skin. With time this will be less noticeable. I suspect that you are still going to have a crooked columella  when all swelling goes away. The reason could be that prior to surgery you had a deflection or that somehow during your open rhinoplasty procedure the columella became deflected. I would have a talk with your doctor, as I'm sure he wants to do what's best for you. I would wait for several months before I would do any other surgical procedure. 

Carlos Wolf, MD
Miami Facial Plastic Surgeon
4.9 out of 5 stars 70 reviews

Revision likely necessary

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With time, the appearance of the incision should improve but likely a revision will be necessary.  Right now the best thing to do is to maintain close follow-up with your surgeon and let your nose heal.  

All the best! 

Babar Sultan, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 9 reviews

Columella incision healing

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Thank you for the question and photos.  Although we do not have your before photos to see how your columella looked before surgery it does appear that a revision may be needed to correct the current columella incision appearance.  Luckily this can be done under local anesthesia fairly easily.  I would set a time frame with your plastic surgeon to allow for healing and then decide when the revision would take place if it has not corrected with healing alone.

I hope this helps.

All  the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 173 reviews

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