Had rhinoplasty 1.5 years ago; not happy with the results for various reasons. The main reason is it appears my septum was not straightened, & you can see it sticks out of my (L) nostril, making my nose between the nostrils veer to the right. Also my (R) nostril is already higher than the (L). He says nothing can be done about the retracted nostrils & he can only minimally improve the columella show, because of height ratio of my nostril versus the base of my nose (under the columella).True?
Answer: Shortening of the columella There are a variety of ways to shorten a hanging columella, which is often one of the tell-tale signs of having had a rhinoplasty, in particular where resection of part of the lateral alar cartilages was performed.
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Answer: Shortening of the columella There are a variety of ways to shorten a hanging columella, which is often one of the tell-tale signs of having had a rhinoplasty, in particular where resection of part of the lateral alar cartilages was performed.
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April 22, 2018
Answer: Correction of columellar show and nostril retraction Thanks for the question and photos. Your columella and infratip are on the heavy side. They could be lifted/shortened with a septocolumellar suture. As for the nostril rims, there are suture techniques which can improve the shape of the lower lateral (tip) cartilages, simultaneously lowering the nostril rims. Your tip could be made more defined, should you desire. There’s a before/after photo in my website gallery of a patient for whom this was done. If needed, rim or strut grafts can be used to lower the nostrils. In severe cases, composite grafts from the ear can be used, though this is quite unlikely in your case. I’d suggest consultations with two or three revision rhinoplasty experts. Computer imaging can help you communicate your aesthetic goals and understand what is possible.
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April 22, 2018
Answer: Correction of columellar show and nostril retraction Thanks for the question and photos. Your columella and infratip are on the heavy side. They could be lifted/shortened with a septocolumellar suture. As for the nostril rims, there are suture techniques which can improve the shape of the lower lateral (tip) cartilages, simultaneously lowering the nostril rims. Your tip could be made more defined, should you desire. There’s a before/after photo in my website gallery of a patient for whom this was done. If needed, rim or strut grafts can be used to lower the nostrils. In severe cases, composite grafts from the ear can be used, though this is quite unlikely in your case. I’d suggest consultations with two or three revision rhinoplasty experts. Computer imaging can help you communicate your aesthetic goals and understand what is possible.
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April 22, 2018
Answer: My plastic surgeon says my columellar show cannot be fixed?? The photographs demonstrate a significant hanging columella which can be addressed with a columella-plasty. This can be performed with a closed Rhinoplasty technique, not an open technique, with the incisions placed completely on the inside of the nose. In addition, tucking the columella inwards will help camouflage the visible open rhinoplasty scar. Choose your second surgeon wisely based on extensive experience
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April 22, 2018
Answer: My plastic surgeon says my columellar show cannot be fixed?? The photographs demonstrate a significant hanging columella which can be addressed with a columella-plasty. This can be performed with a closed Rhinoplasty technique, not an open technique, with the incisions placed completely on the inside of the nose. In addition, tucking the columella inwards will help camouflage the visible open rhinoplasty scar. Choose your second surgeon wisely based on extensive experience
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April 22, 2018
Answer: Alar retraction.... Preoperatively, you had a very prominent dorsum, long nose and over-rotated tip which required a significant resectional techniques.... although these are routine maneuvers in rhinoplasty surgery, my (and other rhinoplasty surgeons’) preference is to implement structural grafting in order to prevent rotational, contracture and collapsing issues....It appears that your columellar/philthal angle and tip projection are reasonable... your nostrils are somewhat retracted which ‘shows’ too much of your columella.... this along with your tip asymmetry will require techniques which release scar contracture and restore structural support...Good luck..
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April 22, 2018
Answer: Alar retraction.... Preoperatively, you had a very prominent dorsum, long nose and over-rotated tip which required a significant resectional techniques.... although these are routine maneuvers in rhinoplasty surgery, my (and other rhinoplasty surgeons’) preference is to implement structural grafting in order to prevent rotational, contracture and collapsing issues....It appears that your columellar/philthal angle and tip projection are reasonable... your nostrils are somewhat retracted which ‘shows’ too much of your columella.... this along with your tip asymmetry will require techniques which release scar contracture and restore structural support...Good luck..
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Answer: Need Second Opinion The right thing to do is always go back to your original surgeon. However if you’re not totally satisfied by that consultation it is entirely appropriate to move on to a second opinion. The more you learn about your particular situation the more empowered you will be to make the right choice for yourself. My consumer friendly book titled When Your Nose Doesn’t Fit “ might be of some help. Visit my website or call my office for a copy. Dr. Michael Sullivan Sullivan Centre Columbus, Ohio
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Answer: Need Second Opinion The right thing to do is always go back to your original surgeon. However if you’re not totally satisfied by that consultation it is entirely appropriate to move on to a second opinion. The more you learn about your particular situation the more empowered you will be to make the right choice for yourself. My consumer friendly book titled When Your Nose Doesn’t Fit “ might be of some help. Visit my website or call my office for a copy. Dr. Michael Sullivan Sullivan Centre Columbus, Ohio
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