Is it possible to fix alar retraction and retracted columella at the same time?

I want to lower my columnella AND fix my retracted nostrils. Am I assuming correctly this will be difficult because lowering my columnella by itself will make my nostrils look even more retracted than they already are? I know for a fact that my columnella and nostrils are too high. I need both of them brought down. Not one up and the other down. Do both of my requests work against each other ? Is this too strange of an issue?

Doctor Answers 11

Alar and columellar retraction

It is uncommon to get alar and columellar retraction? Is your nose short over all? Please provide a photo or make a consultation to discuss details of your surgery. The answer to your question is that any region can be fixed to your liking within reason.


Orange County Plastic Surgeon
4.9 out of 5 stars 44 reviews

Fixing Alar retraction and retracted columella simultaneously

  A full  Set of photographs are required before making any  determination.  It is very difficult to discuss a difficult surgical revision procedures without a full set of pictures present. Fixing alar retraction and a retracted columella are very difficult  procedures.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Lowering of Columella and correcting Alar Retraction

Your question did not give information WHY the ala(e) may be constricted and columella pulled in. That information is quite important. But, in general both CAN be corrected in the same procedure. To do so would require directional, fixed cartilage grafts which resist the scar pull and push these structures forward.

Good Luck

Peter ALDEA MD
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 102 reviews

Correcting both columella and alar retractions

Yes, it is definitely possible to do both at the same time. Cartilage grafts are usually necessary to lower the columella, and either a composite graft of skin & cartilage or just a V to Y advancement of the internal lining is necessary to lower the nostril rim, depending on the degree of retraction.

Stephen J. Pincus, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 2 reviews

Is it Possible to fix both Alar and Columellar Retraction?

Absolutely, and at the same time. This usually requires placement of cartilage grafts. These are 2 separate problems that can be fixed to accomplish proper balance. I need to see pictures to make more specific recommendations.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Revision rhinoplasty to correct alar retraction as well as columellar? retraction

Revision rhinoplasty to correct alar retraction as well as columellar retraction? This is possible and u can see examples of this on my website as well as others. An examination is needed. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 32 reviews

Is it possible to fix alar retraction and retracted columella at the same time?

It is possible to lower both the alae and the columella at the same time. An in office examination would be needed for a proper diagnosis and then a surgical plan would be devised to best address your concerns. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 199 reviews

Revision Rhinoplasty

Thank you for the question and at a complimentary consultation aided by digital photography and your input you will be able to see what is possible and learn how it might be performed.  So see some experts in your area that use this technique.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 59 reviews

Alar retraction

Hello and thank you for your question.  This is a great question for a challenging problem.  It is possible tofix this problem.  I recommend alar batten cartlage grafts to address the alar retraction and a columellar strut graft the lower the columella.  With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 79 reviews

Is it possible to fix alar retraction and retracted columella at the same time?

It's very difficult to address your question without a photo or an in person exam.  I would suggest visiting with a plastic or facial plastic surgeon to review your concerns. An in person exam can help to establish some (realistic) goals for surgery and outcome.  It is possible to lower both the alae (e.g. with composite grafting) and columella (e.g. with cartilage grafting) during the same surgical setting, effectively lengthening the nose.  Whether this is appropriate for you or not is best discussed with a nasal specialist.  Good luck!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 42 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.