Posted underRevision Rhinoplasty q&a
Lost tip projection, roundness. Is it possible to remove the septal extension graft and reintroduce a columella strut? (Photos)
Hello, I had a primary surgery many years ago which left me with a tiny nose. I was only young (19 years old) and very much regret it. I had a revision a year later which built up my dorsum and lengthened the tip. It was a columellar strut and a tip graft that was used. I lived with this nose for 15 years and was okay with it but there were irregularities on the dorsum. I had a revision this year to fix these. I stressed that I did not want the tip to be changed or the grafts removed as I hated it when it was smaller. I said this to my doctor multiple times as well as in emails. He said he would try to keep the columellar strut but if not then then would replace with a septal extension. I am unhappy with the result, and knew immediately that the tip had been changed. The strut has been removed and has caused caused loss of projection, less roundness and fullness in infra tip tip and columellar, and just looks less feminine and does not suit my face. I realise in the photo it may look quite minimal but as my nose tip was small, and my philtrum and face quite long, I couldn't afford to lose any length or projection. I really just wanted my tip to stay the same. Please could you advise what my options are now, would it be possible to remove the septal extension graft and reintroduce a columella strut? The septal extension graft is not adding as much length or projection as the strut did (the strut was thick as I could feel it in Columellar but it isn't there now).
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