Crooked columella - what type of revision surgery do I need? (photos)

Question

Hi, I had Septorhinoplasty in 2020 to fix a deviated septum, however all though my nose looks straight from a front veiw my columella is not, as I had this done on the NHS for medical reasons the consultant said that fixing the columella is classed as cosmetic, what surgery do I need to look into and will it make my nostrils look straight? Thanks in advance.

Randal Haworth, MD, FACS · Answer

If you are unhappy with the appearance of your columella following your septorhinoplasty, there are surgical options that may help to improve its appearance.

One option is to undergo a revision septorhinoplasty, during which the surgeon can make adjustments to the septum and columella to achieve a more aesthetically pleasing result. This procedure may involve reshaping the cartilage and soft tissue of the columella, repositioning the tip of the nose, or adjusting the nostril size and shape to create a more symmetrical appearance.

It is important to note that any surgical procedure carries risks, and a revision surgery may require additional recovery time and may not always result in the desired outcome. It is crucial to seek the expertise of a board-certified plastic surgeon who specializes in rhinoplasty and revision surgery, to evaluate your specific concerns and to develop a personalized treatment plan to help you achieve your goals.

During your consultation, the surgeon will examine your nose and discuss your concerns and aesthetic goals. They will be able to recommend the appropriate surgical technique for your specific case, and explain how it may impact the appearance of your nostrils.

I hope this helps,
best of luck !

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.From the photos you provided you nostrils looks uneven, your nasal bridge is deviated and crooked. I recommend you a revision rhinoplasty surgery to correct it.
Best regards!Prof. Dr. Selcuk Inanli

Jonathan Kulbersh, MD · Answer

Thank you for your question and I am sorry you are unhappy with the results of your first septorhinoplasty. After this procedure, it's possible to have asymmetry in the columella. To correct it, a surgical procedure called a columellar strut graft can be performed. This may not address any nostril asymmetry, which may require additional surgery.

Keep in mind that subsequent nose surgeries become even more complex, due to factors like scar tissue and loss of structural support after the first procedure. A consultation with a board-certified facial plastic surgeon with expertise in revision rhinoplasty techniques is recommended to determine the best course of treatment.

Eric M. Joseph, MD · Answer

To determine what procedure would be best for you, and examination would need to be performed. Based on your photos, I suspect that the bottom of your nasal septum is still deviated into the left side of your nose. This appears to be causing a bulge of the left medial crural foot plate, and a slight drift of your tip towards the right side. Please consider consulting with several reputable rhinoplasty specialists so you can see what might be best for you moving forward. I hope this is helpful. Sincerely, Dr Joseph

Crooked columella - what type of revision surgery do I need? (photos)

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