Columnella Was Lined Up with the Middle of my Teeth, and my Teeth Are Crooked?

Shouldn't the surgeon have checked for symmetry first before using the crack between my two front teeth as a guide for the rhinoplasty? I feel like a fool with the nose tilting to aim for the off center midline. That could have been fixed with orthodontics but now...if I do that the nose will be way off!

Doctor Answers 6

Asymmetric result following rhinoplasty

Hello, and sorry to hear about the result you experienced. Typically, any modifications made to the nose should use the entire face as a model of symmetry. In general, the side effects of a rhinoplasty may include the following:

1) Swelling
2) Asymmetry
3) Congestion
4) Bruising
5) Bleeding

Every patient will have some degree of asymmetry following surgery. Without seeing photos, it is difficult to provide you with any advice. How long has it been since you have had your procedure? And you are sure your teeth were used as a guideline? Depending on how long it has been since your procedure, swelling may cause the appearance of asymmetry, and it will be necessary to give yourself some time to heal. For now, I would recommend discussing any concerns with your surgeon. I hope this helps, and best of luck to you.

Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

Nose deviated or tilted after surgery

Most people have some asymmetry between the two sides of their face, whether it's the nose, eyes, overall bony structure, etc. When doing a rhinoplasty, the goal is to center the nose in context of the face, and give the "illusion" of symmetry even if the rest of your face is not symmetric. The teeth aren't generally used as a guide for symmetry during rhinoplasty, so I'm not sure why you think your surgeon used this as a guide or reference for your columella. The position of your columella can be altered by changing the position of the septum or nasal spine, or by the positioning of columellar strut grafts, but the columella itself is not a structure that is moved around for it's own sake. If your nose looks tilted after surgery there can be many reasons why, and it is really important for you to ask your surgeon about this, since he or she knows what the internal structure looks like.

Anita Patel, MD, FACS
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 12 reviews

Uneven Columella

Dear Esperanza, Position of cullumella has nothing to do with the appearance of teeth. No plastic surgeon uses teach as reference point for the cullumella correction , I am sure you have some confusion. Better to check with your PS. Wishing you good luck

Columella and teeth

Usually the position of the columella stays the same unless there was significant deviation that required respositioning.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Uneven Columella

Dear Esperanza, Perhaps there was some misunderstanding regarding your surgery and alignment of the columella to the teeth. I have been performing rhinoplasty for 30 years and never do I use the teeth for symmetry. I would see your surgeon and further discuss this issue. Best regards, michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 210 reviews

Columella Lined Up on Middle of Teeth

   Did your surgeon tell you that the teeth were used for the alignment of the columella?  I have never used this to align or as a reference for the columella.  Did you have asymmetry before?  The columella does not usually change much in many rhinoplasties unless the anterior nasal spine is manipulated.  Even then, the columella does not really shift much.  If you posted a picture, I could give you better insight.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 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.