Req second opinion: Is a revision rhino for shaving down the supratip and removal of hanging columella very complex? (Photos)

Question

I'm 8/mos post op, and I have had 2 rounds of kenalog injections (once at 3 months post op, and another at 5 months post op). My primary surgeon is willing to do the revision for free. The things I would like done are: 1. Shave down the hump of my supratip 2. Get rid of the excess, hanging columella. I believe this hanging columella occurred due to the alar retraction of my primary rhinoplasty. How complex would this revision be?

Thomas A. Mustoe, MD, FACS · Answer

Your shape is commonly seen after rhinoplasty and is due mostly to loss of tip projection during the healing process which has also caused excess columellar show ( hanging columella). A formal revision rhinoplasty would be required with resection of scar tissue and increased tip support with a strong columellar strut graft or septal extension graft.  This is best achieved with an open rhinoplasty approach and best delayed until a fulln12 months after the first operation.  Any revision rhinoplasty is more complex than the primary rhinoplasty but in an experienced surgeon’s hands your goals are realistic.

William Portuese, MD · Answer

Revision rhinoplasty is always more difficult than a primary rhinoplasty due to the fact that there have been previous alterations to the normal anatomy and scar tissue present.  Thick skin in the tip of the nose prevents refinements in that area, so  it is important to have realistic expectations.  The digitally altered photographs do appear realistic.

Req second opinion: Is a revision rhino for shaving down the supratip and removal of hanging columella very complex? (Photos)

Answers (2)