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

Question

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.

Thomas A. Lamperti, MD · Answer

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.

Ryan Greene, MD, PhD · Answer

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.

Steven Wallach, MD · Answer

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.

Richard W. Fleming, MD (retired) · Answer

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.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

	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.

	Best,

	Dr.S.

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

Answers (5)