My doctor completely removed my columella, is there any way I can get my nose to be like my before picture? (Photo)

Question

First pic is me. My birth nose was very long and unfortunately my doctor completely removed my entire columella without my consent. I also have a very scooped dorsum. I was only supposed to get a hump removal and narrow bridge. My dr did so much more. Is there any way I can't get something like my before or the wish pics?

Jeffrey H. Spiegel, MD · Answer

Yes, it should be possible to improve your nose. The tip of your nose is full and the columella is in, but, that should be fixable.

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. Fortunately, I think you will likely be a good candidate for a cartilage graft to improve the appearance of your columella. While your columella may not appear as prominent as before, a skilled facial plastic surgeon has the necessary training to boost its size subtly. I strongly recommend visiting a board-certified facial plastic surgeon with plenty of experience performing rhinoplasty and revision surgeries.

Andrew Miller, MD · Answer

Things you are asking for can be improved with revision rhinoplasty. A septal extender graft and tip work can extend the length of the nose and the columella, and a graft can help rebuild the bridge. It might not look exactly like the desired photos you show, but should be a nice improvement.

Samuel Lin, MD, FACS · Answer

Thank you for your question-- yes changing the position of the columellar area in a patient who has or has not had surgery before usually relates to what is inside the nose, cartilage that is present for structure, and the skin.  I would encourage patients to followup with their original rhinoplasty surgeon...

Waleed Ezzat, MD, FACS · Answer

Thank you for your question. I’m sorry to hear that you were unhappy with your first rhinoplasty. By the pictures provided and the description in your question, you would likely benefit from a secondary procedure. It is probably best to wait close to a full year from your first procedure and keep in touch with your surgeon. If you are within that first year you still have some healing to do. If you are close to the one-year mark, I recommend seeking out a board-certified specialist who has extensive experience in revision rhinoplasty. You will likely need cartilage grafting in order to get you close to what you are hoping for.

Best of luck to you.

Dr. E

Best of luck to you.

Dr. E

Akshay Sanan, MD, FACS · Answer

Dear unhappygirl22,
Thank you for uploading your photos and I am sorry to hear about your rhinoplasty. To improve your columella, you will likely require a cartilage graft to push the columella outwards and give it's form again. With regards to the scooped dorsum, there are surgical techniques to restore the dorsum height. I recommend you consult with a board certified facial plastic surgeon to discuss your goals and realistic outcomes. 
All the best,Dr. Sanan, MDLos Angeles, CA

Cem Altindag, MD · Answer

Hi, thank you for your question.With cartilage grafts (your own), surgery may be planned to restore the bridge and columellar area. They should be prepared precisely ( general anaesthesia). Revision surgery is ideal treatment. Best. Dr.Cem Altindag

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