Columella continues dropping after 6 months. Do I need a revision? (photo)

Question

Hello, I had a rhinoplasty 6months ago, and my columella seems like it’s showing more and more. I don’t know if it’s because I yawned really hard when I’m tired and it pushed it down. Or if it’s still swollen, it’s still really hard but I don’t know if it’s the graft Do you think I will need a revision ? Here’s my nose 1months post op and 6months

Jonathan Kulbersh, MD · Answer

Thank you for your question and photo. Though much of the swelling is reduced within four months, your nose will be in a phase of recovery for at least one year following your rhinoplasty procedure. It is generally suggested to wait until this entire recovery process is complete to evaluate the final results before considering a revision procedure. If you’re still unsatisfied with your nose’s appearance at this time, the columella can be slightly raised and corrected during revision rhinoplasty. Keep in mind that each subsequent nose surgery becomes more complex due to loss of structural support, scar tissue, and other factors. The importance of experience, expertise, and artistry cannot be overstated. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to oversee your recovery, answer any questions you may have, and help you decide on the steps needed to achieve your aesthetic goals.

Barry M. Weintraub, MD, FACS · Answer

Judging from the photograph you submitted, it appears that you have too much nostril show visible on the right nasal aperture. High-quality cosmetic nasal surgery is detailed and complex, always with a keen eye towards natural beauty. This can be fixed by raising the columella ever so slightly and making the nasolabial angle a bit less obtuse so the columella does not appear to hang. This is something that is commonly seen in my practice. Thank you very much for your inquiry and the ability to respond to your issue.

William Portuese, MD · Answer

Yes, the photo does demonstrate a hanging columella. Probably best to wait closer to a year before undergoing any revision rhinoplasty to reduce the hanging columella. This can be performed with a closed rhinoplasty approach with all the incisions placed on the inside of the nose. No external incisions are required, and no painful packing is required either

Columella continues dropping after 6 months. Do I need a revision? (photo)

Answers (3)

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