Nostril Show After Rhinoplasty, How can this be Fixed? (photo)

Question

My concern is too much nostril show after a recent rhinoplasty. I understand a columella lift is possible. By applying digital pressure I can see this will solve the nostril show, but will make the tip appear even more drooping (it already is, although it could be simply swelling). Will a lifting of the columella and trimming some of the cartilage in the area be a solution? How soon can this be performed? Would any grafts be indicated? How would you approach the problem? Thank you for your time.

Eric M. Joseph, MD · Answer

I read your concern and reviewed your photo:

	You may be able to achieve a few millimeters of nostril lowering without undergoing a revision rhinoplasty. My experience with Silikon-1000, an off-label filler for permanent results, has been rewarding for reducing nostril show. I've attached a photo demonstrating permanent non-surgical nostril lowering.

	I hope this helps you.

	Dr. Joseph

Howard Webster, MBBS (Hons), FRACS · Answer

Without seeing preop photos, or knowing how long it is since surgery, and with such a poor quality postop pic it's very difficult to offer you meaningful advice. The advice would be different if you were 2 weeks postop vs 6 months postop.
If you're very recent postop, wait 6 months and then reassess. It will change a lot over that time.  If you're 6 or more months postop, then you're best to have a consultation with your surgeon or obtain a second opinion. It might be that a tip complex revision is required to meet your needs. But without a full history, preop pix, and examination both extra and intra nasal advising you can only be general and not especially helpful for you.

Philip J. Miller, MD, FACS · Answer

Do you not like that the rim is too high or that you see too much columella? Do you wish for the tip to be raised a bit, or the rim brought down. Both can be achieved though through different techniques.

Francis R. Palmer, III, MD (retired) · Answer

Increased columellar show can easilly be corrected using a columellar tuck as an isolated procedure that does not require a Rhinoplasty. be sure your Rhinoplasty Surgeon understands and follows the proper aesthetics of facial (and nasal) beauty for the creation of a naturally, attractive nose.

Richard W. Fleming, MD (retired) · Answer

You don't mention when your rhinoplasty was done, but after waiting 9-12 months the columella can be raised and the tip slightly rotated by removing septal cartilage immediately above the columella. I cannot tell from the picture submitted, but small cartilage grafts can easily be placed at the nostril rim if there is alar retraction.

Nostril Show After Rhinoplasty, How can this be Fixed? (photo)

Answers (5)

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