How can you thicken a columnella after a rhinoplasty?

Question

After rhinoplasty, my columnella is very thin, making my nostils appear much wider than they are. How can u make them thicker? Is it even possible and is it a simple procedure? Can I just add filler to the columnella or surrounding nostril area to make the nostrils appear smaller?

Jacob Sedgh, MD · Answer

It would be difficult to comment without any visuals, but in general cartilage grafting is a common technique to reinforce or augment subunits of the nose during a rhinoplasty.

Thomas A. Lamperti, MD · Answer

Columellar thickness isn't a particularly common issue aesthetically, but it is possible to widen the columella with a cartilage strut placed between the two adjacent columellar cartilage (medial crura).I wouldn't recommend filler injection to that area to try to widen it as there's a greater risk of skin injury and it is more likely to make the columella hang downward rather than become wider.

Juan Carlos Fuentes, MD · Answer

The nasal columella can be thicken with a filler if the patient is a good candidate, and it will be the easiest way to do it and also as it is reversible it will give the patient a better idea about what the results can be. Other options are the use of a cartilage graft.

Evan Ransom, MD, FACS · Answer

Thank you for the question. This is an uncommon request, but in some cases patients will have a very narrow columella (skin between the nostrils). The absolute best fix for this is a small cartilage graft placed between the medial crura (the legs of the tip cartilages in the middle of the nose). This cartilage can come from the septum (best option) or other sources (ear, rib, etc.). Non-surgical options are possible but will not likely provide as good a correction. Placement of fillers in this area, particularly after a surgery has been performed, is not likely to be very useful. There will be scar tissue, limiting the movement of the filler into the tissues; plus, there is some danger that this will compromise the blood supply of the skin in this area. Best of luck moving forward!

Toby Mayer, MD · Answer

Widening the narrow columella? Fillers usually will not give a good result  because of scar tissue.  Cartilage taken from your septum can be placed within the columella to give you what you desire. See a very experienced revision rhinoplasty specialist for this.

Mohsen Tavoussi, MD, DO · Answer

If you wish to have your columella wider or thicker, a cartilage graft will achieve that. But, I recommend that you have a consultation with a rhinoplasty surgeon in order to evaluate what may necessary to have balanced nose.Best

Jeremy B. White, MD · Answer

It is difficult to give you specific advice without an in person consult or, at least, photos. The columella can be made wider or lower with cartilage grafting. I do not advise placing filler in this location as the filler may cause a problem with blood supply to the area and cause a problem with the skin. Your nostrils can also be made more narrow, if needed, with other techniques. Make sure that you wait at least a year after your initial rhinoplasty before pursuing this since your nose undergoes a lot of change during that first year of healing.

William Portuese, MD · Answer

A rhinoplasty procedure usually does not make the columella thinner. If the columella is too thin, a cartilage graft harvested from inside the nose can accomplish widening the columella. If the nostrils are excessively wide, consider an alar-plasty

David Alessi, MD - Account Suspended · Answer

Filler may help but I suspect that there will be to much scarring and the filler will go in the wrong place.  The best option is to graft the columella and add more width with an unfurling technique.  Seek out a board-certified revision expert.  Best wishes.

Richard W. Fleming, MD (retired) · Answer

Pictures would be helpful but the best permanent solution to increasing the width of a thin columella is with a small cartilage graft. Although fillers can be very useful I don't like to use them in the nasal tip.

How can you thicken a columnella after a rhinoplasty?

Answers (10)

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