Hanging columella and possible alar retraction after rhinoplasty. Is it easy to fix? (Photo)

Question

I had an open rhinoplasty years ago. Since then, nostrils are very visible on both side views and straight views. Is this easy to fix? Is it possible to fix without another open surgery? Attached is a photo to provide an idea of what I'm thinking about. Thank you in advance.

Eric M. Joseph, MD · Answer

If your hanging columella is due to excessive nostril skin (membranous septum), excision of excess on both sides with a primary repair could be considered with minimal inconvenience or downtime - "Columellaplasty". If your tip cartilages need to be reconstructed, this may be a more involved procedure. Hope this helps! Dr Joseph

Scott Trimas, MD · Answer

The short answer to your question is that yes it is possible to correct the alar retraction and columella show with a closed approach; however, that would depend upon a physical examination and review of the old operative reports, if available. It could be a very minor procedure or it could be more involved depending upon what was done previously. I would seek a board certified facial plastic surgeon or revision rhinoplasty expert in your area.

Thomas Trevisani, MD · Answer

Revision Rhinoplasty is a very precise operation that requires a very precise and detailed physical exam and a skilled and talented Surgeon . Nothing about Rhinoplasty is "easy" - it's a challenging procedure - but in the right hands- very rewarding. In our Practice - in most cases- we perform all Rhinoplasty procedures including- revision Rhinoplasty though closed technique.

William Portuese, MD · Answer

Revision rhinoplasty is more difficult than a primary  rhinoplasty, and both procedures are some of the most difficult operations  to perform correctly in the entire field of cosmetic surgery. The hanging columella can be reduced with a columella-plasty. To reduce alar retraction requires a composite graft of both skin and cartilage harvested from the ear. For many examples, please see the link and of the video below

Steven Wallach, MD · Answer

AN evaluation in person is necessary. Sometimes this is alar rim retraction rather than true columella excess. The two are treated differently.

Harry V. Wright, MD · Answer

These refinements can be obtained with a revision surgery. I do not feel that it would require opening the nose again. Do yourself a favor and seek out a surgeon who has demonstrated proficiency in revision rhinoplasty.Best wishes!  Harry V. Wright MD, Sarasota, Florida

Daniel Greenwald, MD (in memoriam) · Answer

The photo shows only one view of a very nice tip profile.  If in the frontal view the nostrils are too visible then a slight elevation of the base of the columella (where your finger is pushing) might help.  This could probably be performed safely in an office-type setting under local anesthesia.

Hanging columella and possible alar retraction after rhinoplasty. Is it easy to fix? (Photo)

Answers (7)

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