How soon after revision rhinoplasty can hanging columella be raised?

Question

I had a revision rhinoplasty 8 months ago, and I am very unhappy with my results. My hanging columella was not corrected. Would it be possible to raise the columella at 9 months post op instead of waiting the full 12-months?

Alejandro Nogueira, MD · Answer

A revision could be done after 9 months, it all depends on your nasal tissues condition and recovery, notwithstanding the common safety envelope covers a cool down of 12 or more months.Regarding hanging columella it is a myth, does not exist but in elder people, really aged and beyond 60s or older.A, correctly said, prominent columella is of TWO kinds, which are really three:-PROTRUDING columella: the columella is so prominent (due to thick or broad medial cruras and thick subseptum, or due to ethnicity like in arab noses with too long lateral cruras pushing down the medial cruras) to arise in excess (normal is 3-5 mm) below the nostrils or alae level-EXPOSED columella: the columella is not prominent or oversized, it is just the alae or nostrils suffer alar rim retraction, congenital or iatrogenic (after rhinoplasty) and do not cover sufficiently the columella-hybrid situations, not uncommon, in which part of the problem is a protruding columella and other part can be attributed to rim retraction; this is a tricky situation and can be misdiagnosed by the surgeon, tending to think in black and white terms putting all the issue to the columella or the alae, which can be catastrophic or in the best case end in merely partial correctionOnce again, excepting very old patients, columella is not a hanging part.The treatment protocol is as follows:-protruding columella: address the cause, normally this is best done with powerly thus very delicate tongue-in-groove securization technique by which the medial cruras as narrowed and lifted up using the pre-existant or newly built caudal septum-exposed columella: lateral crura customly designed caudal extension batten grafts (some surgeons advocate the composite grafts, I don't like them, unreliable)-and in hybrid scenarios might be the former both togetherCorrecting an exposed and or protruding columella is not a simple maneuver and should be done ONLY by highly experienced surgeons, you run the risk of ending with a sunken columella piggy-style or something worse. It is a top-notch surgical maneuver.If you wish better grounded opinion please do post or send privately well lit, focused and standard images: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

Richard W. Fleming, MD (retired) · Answer

If the hanging columella is your only problem this can be revised and elevated at any time now that you're 9 months after your previous surgery. This can be done under local anesthesia and recovery will not take a long time.

How soon after revision rhinoplasty can hanging columella be raised?

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How soon after revision rhinoplasty can hanging columella be raised?

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