I have what appears to be a deformity in my columella. I am a 31 year old male and have had this condition since birth. In addition to having a very defined "ridge" between the two sides of the columella, it also appears that the right side hangs, while the left side does not hang. Furthermore, the ridge between the two sides of the columella, it not straight - it sort runs diagonal between my nostrils. Is a correctable condition and what the process would involve? Thank you!
February 23, 2016
Answer: Columellar strut graft Hello and thank you for your question. Based on your photographs, it is possible to perform a columellar strut graft. This will correct your asymmetry and the two ridges you see. The most important aspect is to find a surgeon you are comfortable with. 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, M.D.Harvard-trained plastic surgeon
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February 23, 2016
Answer: Columellar strut graft Hello and thank you for your question. Based on your photographs, it is possible to perform a columellar strut graft. This will correct your asymmetry and the two ridges you see. The most important aspect is to find a surgeon you are comfortable with. 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, M.D.Harvard-trained plastic surgeon
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Answer: Congenital abnormality of columella and nasal tip Yes you are correct. You have a condition known as bifid tip with asymmetry where the tip cartilages are not bound together in a symmetrical fashion. This has also resulted in a deep crease or cleft of the columella skin. The caudal septum may also be deviated but unable to tell from the photos. These issues can certainly be improved with rhinoplasty. The procedure would attempt to restore symmetry to the tip cartilages as well as ensure that they are adequately supported. Correction of the deep crease in the columella should improve but may not go away completely. Optimum improvement of the columella crease may require both a columella cartilage graft and a staged (at least several months after rhinoplasty) fractional CO2 laser treatment of the involved columella skin.
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Answer: Congenital abnormality of columella and nasal tip Yes you are correct. You have a condition known as bifid tip with asymmetry where the tip cartilages are not bound together in a symmetrical fashion. This has also resulted in a deep crease or cleft of the columella skin. The caudal septum may also be deviated but unable to tell from the photos. These issues can certainly be improved with rhinoplasty. The procedure would attempt to restore symmetry to the tip cartilages as well as ensure that they are adequately supported. Correction of the deep crease in the columella should improve but may not go away completely. Optimum improvement of the columella crease may require both a columella cartilage graft and a staged (at least several months after rhinoplasty) fractional CO2 laser treatment of the involved columella skin.
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