Can a revision rhinoplasty restore a curved columella?

Columella deformity following an unsuccessful nasal surgery can be related to many factors, the main ones being mishandling/unfavorable healing of the columella cartilage or deformities of the bottom part of the septum which may distort it as its intimate anatomic neighbor. Such conditions are common issues addressed during a revision rhinoplasty and often demand precise cartilage grafting via an open approach.

My sincerest apologies for having a bad experience with your rhinoplasty.  I feel that you may have not seen a surgeon whom specializes in the face, which now is of utmost importance.  With regards to recreating a curved columella, or the re-establishment of the infra-tip break, this can be done with cartilage grafting techniques that can carefully be done.There are several talented Facial Plastic Surgeons in your region to choose from.  I hope that this helps.

Restoring a natural curve to a columella on revision  is challenging.  You are correct that it is easier to straighten a columella than produce one that is more curved, and can only be done with cartilage grafting. The challenge is to do this without the cartilage graft having a visible edge.   An in person consultation really is necessary.  If the tip projection is lowered, that will increase the curve of the columella but that may not be cosmetically desirable.  Choose your surgeon carefully, and seek more than one opinion.

I recommend getting a consultation to go over your concerns and your desired results. Revision rhinoplasty is a technically challenging procedure and I would suggest that you seek a surgeon that has a good track record for natural results. There a few select of these surgeons in each major city.  I would look at their reputations, board certifications, and before and after pictures.  
I hope this helps.

Yes, you can be helped. And surgery, with a cartilage graft, is one of your options. However, you should consider filler. Impossible to determine without a consultation but many people have had an imperfect columella fixed, without surgery, using filler. Best wishes.Robert Kotler, MD, FACSBeverly Hills, CA

Much more information is needed such as operative reports, a full set of photographs and an in-  Person examination due to the fact that a revision rhinoplasty is more difficult than a primary rhinoplasty.  There has been previous anatomical changes to the nose anatomy and scar tissue present.  It is important to know how much cartilage is left on the inside of the nose for potential grafting purposes.

Yes, revision rhinoplasty can restore an over-resected columella. This can be done with lightly crushed cartilage grafts. See a board certified plastic surgeon for more specific details.

Dear Gioa, Its time to start going to some revision rhinoplasty experts in your area for consultation and secondary opinions and discuss all of your current concerns. This will be the best format for you to be evaluated and tell you what you can expect from revision rhinoplasty. Best regards, Michael V. Elam, M.D.

Yes, the contour of the columella can be improved with a cartilage graft during revision rhinoplasty. With all of the problems you've described in previous posts I suggest you consult with a revision rhinoplasty specialist.