Revision Rhinoplasty - Will Flatness / Indentation at Infratip at Columella Smooth Out? (photo)

I had revision rhinoplasty on 10/5/11 (1st surgery 5/4/10) to correct and refine my tip. I understand my nose is still swollen and it will be swollen for some time. However, I am very concerned that there may be a cartilage problem causing the unevenness and flat spot on my infratip and columella. I have searched the web to see if other people have experienced the same problem. I can't find anything. Is this unevenness normal? Will it smooth out? I did have one steroid injection after one month.

Doctor Answers 5

Depression of Columella Just Anerior to Open Rhinoplasty Incision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The depression of the infra-tip lobule, anterior to the open rhinoplasty incision, is probably secondary to the size or position of the medial crura and swelling within the columella. This may all improve because you're only 2 months post-op. If any revision is necessary it would be a relatively minor procedure that can be done under local anesthesia.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Infratip lobule indentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

That part of the columella (at the infratip lobule) is composed of the medial crura. Some people have bifidity of these cartilages (even without having had surgery) due their cartilage position and skin thickness which leads to an indentation.

I would give your nose time to heal. It is possible in the future to add an onlay graft to the region to fill in the indentation with a minor office procedure.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Uneven infratip region

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The area that you are concerned about is most likley differences in position of your medial crura.  This also may be some swelling. You would need 6 months to a year for all the swelling to go down before considering a touch-up.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revision Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}


The asymmetry you see in the infra - tip collumela may be due to uneven medial crus of the lower lateral cartilage. Although you are still early post-op it appears that the swelling has resolved in this area. Im not sure it will resolve on its own.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 286 reviews

Flatness at infratip after rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

While it is difficult to judge from your photos, if there is indeed a flat area in the columella, this is likely in the area of the medial crura. My advice would be to give it more time to heal. If it is still present after 6-9 months, discuss a touch-up procedure with your surgeon if still concerns you.

Ryan Greene, MD, PhD
Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 85 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.