Droopy columella after rhinoplasty? 5 months post op.

Question

I had a rhinoplasty in June, I had a tip support graft and I absolutely hated my result. I went back 3 months after to get the graft trimmed/shortened amongst other things in order to "undo" my results. My question is about my columella, I feel it's droopy. It's now 2 months after I got the graft trimmed. What's causing the columella to droop? I do not think my tip needs to be lifted at all, it's solely the columella that's making it appear to be droopy.

Alejandro Nogueira, MD · Answer

It is pretty common, actually it is the most likely scenario when patients complain about columella droopiness or excessive visibility (columellar show), that for real the problem is located at the nostril rims, suffering alar rim retraction, do consider this option.If you wish better grounded opinion well lit, focused and standard images have to be assessed: frontal, both lateral and both oblique views, also underneath the nostrils.
Feel free to request any additional information from me.

Robert Deeb, MD · Answer

Hello and thanks for the question. If you were happy with the columella after the first surgery and then developed the droopiness after the revision, then likely the cause of the issue is having the revision too soon after the initial surgery.  It is generally best to wait ~ 1 year prior to having a revision.  
The droopy columella can often be fixed with a relatively minor revision surgery. I recommend having an open and honest discussion with your surgeon regarding timing and expectations for the revision surgery.  
Hope that helps and good luck.

Deepak Raj Dugar, MD · Answer

Hello,One of the reasons that your columella is droopy is because your nose has gone through trauma. Having more than one surgery in a year can effect the strength of your nose skin, especially near your tip area. Rhinoplasty procedures take a long time to heal because the skin has to remold to the new framework. I would wait a full year to see how your columella heals, and then if it is still droopy consult another doctor for a revision. Best, Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

Ivo Gwanmesia, FRCS(Plast) · Answer

Thank you for your question.This is a very good example where a revision is attempted before 12 months post op. It is never a good idea to attempt a revision before a year is through. This causes intrinsic weakness of the tissues, and disrupts any mechanical support that may have been achieved at the time of the surgery. Even if your tip appeared to be lifted after the original surgery, and because of gravitational pull, the tip would have dropped anyway. My advice to you is to wait a good 12 months from the revision before contemplating any sort of action.Hope that helps.

Droopy columella after rhinoplasty? 5 months post op.

Answers (4)