Closed tip plasty with alar reduction (Photo)

Question

Hello I’m post 6 months from closed tiplasty with alar reduction. I’m noticing my columella is longer and can’t help being fixated on it, especially when I smile because it looks so long. It feels hard to the touch and I feel the cartilage when I move it side to side. Is it possible that it could be swelling and will become smaller?

Donald B. Yoo, MD, FACS · Answer

At 6 months, much of the swelling along the columella has resolved, but it will get a bit smaller as the remaining swelling resolves. In terms of flexibility, it will certainly become much softer and more flexible as swelling resolves and it continues to heal.

Man Koon Suh, MD · Answer

Thank you for your question. The current state of the hanging columella does not seem likely to improve further, even with additional reduction of swelling. Correction of a hanging columella is possible through surgical methods, which vary in detail depending on the individual. However, it generally involves repositioning the lower lateral cartilage and correcting the caudal septum.

Gerald Minniti, MD, FACS · Answer

Your tip appearance is common after a surgery that doesn't address structural support with the use of fixed grafts. Most surgeons who perform closed rhinoplasty do not do any complex maneuvers involving fixed grafts, although some will place onlay grafts, which don't improve structural integrity. Even with the very limited photos you provided, it is also clear that your septum is deviated too. All of these issues can be fixed with an expert surgeon performing revision rhinoplasty, as you can see in my recent 1n5t@gr@m p05t.

Tanveer Janjua, MD · Answer

You had a nice result from your alarplasty and tip plasty. However, sometimes the columella can become loose and hang a bit. This can be corrected easily through columellar reduction. Overall your nose looks excellent. 
Regards
Dr. J

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a revision rhinoplasty to help treat alar retraction and elongated of the columella. Unfortunately, this is not likely to get better with time. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Closed tip plasty with alar reduction (Photo)

Answers (5)

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