How Realistic is It to Shorten Philtrum, Decrease Width of Columella, and Expect Good, Natural Results? (photo)

Question

Had a 1st rhinoplasty/septoplasty in 2005 and LeFort I osteotomy in 2012. My upper lip became less visible and pronounced/uneven nasolabial folds. Septum weakened, tip of nose began to "slide" down. In Dec 2010, had septum "re-built" from rib graft and tip raised. Lots of scar tissue formed; 7 months ago, had another revision---all scar tissue removed. Nose is still bulbous, lots of scar tissue, wide base and philtrum. What would you do knowing my hx and seeing photos?? Thanks!

Ronald J. Edelson, MD · Answer

You had a very tough case and I think your surgeon did a good job. I would advise against any major revisions on your nose but you might benefit from reducing the alar base using small skin wedge excisions. As far as narrowing your philtrum is concerned, it would involve scars that I do not feel would be worthwhile.

Toby Mayer, MD · Answer

You need to see a revision rhinoplasty specialist after at least 9 months for an exam and discussion of the pros and cons of further surgery.

Richard W. Fleming, MD (retired) · Answer

I suggest you wait another 6 months and then consult with a revision rhinoplasty specialist.I understand your concerns and feel you can improve your appearance.

Robert Shumway, MD - Account Suspended · Answer

Yes, I agree with Dr. Mayer.  See your local rhinoplasty specialists and discuss your Nose - Lip goals in detail.

How Realistic is It to Shorten Philtrum, Decrease Width of Columella, and Expect Good, Natural Results? (photo)

Answers (4)