Nose Tip Grafting and Columella Strut 5 Months Post Rhino?

I had open rhynoplasty 5 months ago dr said i needed graft tip and columella strut im so unhappy now it makes my nose look upturn exposing my nostrils making them look triangle will my tip come down more or can i just remove the columella strut so my tip can come a little down

Doctor Answers 6

Tippy Tip

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After 12 months, you should be fairly content with your nasal tip and nostril appearance.  However, in the words of the late Dr. Richard Webster (Father of Cosmetic Surgery): "The nasal tip may be liken unto a TRIPOD, by analogy."  The three supporting legs of a tripod can be surgically adjusted to position the tip (in three dimensional space) accordingly. In turn, this positioning will affect nostril show.

San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Unsatisfied With Rhinoplasty Results

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Dear Bunny1,


I am sorry that you are not happy with your Rhinoplasty results.


My advise is that you wait till you achieve full recovery hence final results. You still have swelling and without photographs and physical examination it is hard to give you a solid opinion.


You have to give it some time so a better assessment of your progress could be possible.


Best of luck to you and thank you for your question.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Unhappy with tip appearance after open rhinoplasty

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I would be helpful to see your photos. It sounds that the rotation and the projection of your tip were increased as a result of the surgery.  Your tip may look appropriate and maybe you are just not used to the new look; another possibility is that your tip rotation and projection are really excessive.  You may see some more changes up to a year after the surgery, but I don't think those will be significant.  My advise is to wait another 6 months or so, see what happens, and consider speaking to your surgeon about the revision if you are truly unhappy at that time.

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

Nostril Show 5 Months after Rhinoplasty

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Wait another 6 months to see changes that will occur as healing progresses. If you and your surgeon are not satisfied the position and rotation of your tip can be adjusted so your nostrils are less exposed.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Nose tip grafting

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Adequate nasal tip support is essential for long term success in rhinoplasty as over time tips may droop. Having said that from what you describe you may be too elevated for your taste. Keep in touch with your surgeon and see how it settles after a year. If it is still up sometimes a simple transfixion incision may settle it back without a full revision. Good luck!

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Over-Projected Tip

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The tip may have been set to high. That can be as a result from several tip maneuvers, collumelar strut, shield graft, dome division, cephalic strip, over-reduction of the bridge etc.  Consult with your surgeon to figure out why and how to correct it.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 285 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.