My nose was also left overly projected and nothing was done with the tip- can decreasing the projection and tip work improve the appearance of the retraction? or would a graft be needed?
Answer: Retracted columella treatment Addressing your tip projection and tip work doesn't really change the columellar retraction, but this can certainly be addressed at the same time during revision rhinoplasty surgery.There's no one proper treatment for the columellar retraction. In isolation a plumping graft in which tissue is place under the skin in the area can help. In other instances different types of cartilage grafts can also be used.
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Answer: Retracted columella treatment Addressing your tip projection and tip work doesn't really change the columellar retraction, but this can certainly be addressed at the same time during revision rhinoplasty surgery.There's no one proper treatment for the columellar retraction. In isolation a plumping graft in which tissue is place under the skin in the area can help. In other instances different types of cartilage grafts can also be used.
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February 9, 2016
Answer: Actually, the retracted columella isn't the big issue on your nose, imo. As you point out in your post, the tip is still very projecting, and the nose is long, with the tip hanging down. Those are common results after rhinoplasty, because de-projecting the nose and elevating the tip require advanced work on the tip cartilages, places where many surgeons fall short.The good news is that 1) elevating and de-projecting the tip are two of the most predictable changes to make in a nose in expert hands, even in a revision, and 2) elevating the nose in particular helps expose the columella.See the "Web reference" link, just below my response: I made a computer morph, and an animation of the morph, to show what your nose might look like with the tip de-projected and elevated. If you watch the animation carefully, you'll also see that I reduced the strength of your nose up where it starts, just below your eyebrows. It's important to reduce that area if we want the nose to look less prominent.I don't see anything here that would require grafting.You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle. Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.
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February 9, 2016
Answer: Actually, the retracted columella isn't the big issue on your nose, imo. As you point out in your post, the tip is still very projecting, and the nose is long, with the tip hanging down. Those are common results after rhinoplasty, because de-projecting the nose and elevating the tip require advanced work on the tip cartilages, places where many surgeons fall short.The good news is that 1) elevating and de-projecting the tip are two of the most predictable changes to make in a nose in expert hands, even in a revision, and 2) elevating the nose in particular helps expose the columella.See the "Web reference" link, just below my response: I made a computer morph, and an animation of the morph, to show what your nose might look like with the tip de-projected and elevated. If you watch the animation carefully, you'll also see that I reduced the strength of your nose up where it starts, just below your eyebrows. It's important to reduce that area if we want the nose to look less prominent.I don't see anything here that would require grafting.You should understand that the changes I demonstrated in the morph require advanced techniques, techniques that most plastic surgeons cannot handle. Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.
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February 8, 2016
Answer: Retraction--how to fix? Dear Ksee,Sorry to hear about your concerns. While it is impossible to tell with certainty from photos, a retracted columella does appear to be present. The over projection is another issue. These can all be addressed with a revision surgery, but would require an in-person examination to tell you more about methods, etc. See an experienced revision surgeon and bring your old photos and operative notes.I hope this helps you!Best,Dr. Most
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February 8, 2016
Answer: Retraction--how to fix? Dear Ksee,Sorry to hear about your concerns. While it is impossible to tell with certainty from photos, a retracted columella does appear to be present. The over projection is another issue. These can all be addressed with a revision surgery, but would require an in-person examination to tell you more about methods, etc. See an experienced revision surgeon and bring your old photos and operative notes.I hope this helps you!Best,Dr. Most
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April 9, 2021
Answer: Retracted columella not the real problem Judging from the photos, it appears that your nose is slightly prominent both with respect to the dorsum as well as the tip. Also, the tip droops or is under-rotated, which gives the illusion that your columella is retracted. Finally, the base of the columella, as well as the tip, is deviated slightly to the right side indicating a minor dislocation of the base of your septum.The good news is that repositioning the caudal septum combined with de-projection and slight rotation of the tip will significantly improve the appearance of your nose. The dorsum will likely require a minor reduction as well to allow better aesthetic balance between the bridge and tip. It should be noted that these changes require advanced techniques that should only be trusted to an experienced facial plastic surgeon who performs revision rhinoplasty on a frequent basis.
Helpful 1 person found this helpful
April 9, 2021
Answer: Retracted columella not the real problem Judging from the photos, it appears that your nose is slightly prominent both with respect to the dorsum as well as the tip. Also, the tip droops or is under-rotated, which gives the illusion that your columella is retracted. Finally, the base of the columella, as well as the tip, is deviated slightly to the right side indicating a minor dislocation of the base of your septum.The good news is that repositioning the caudal septum combined with de-projection and slight rotation of the tip will significantly improve the appearance of your nose. The dorsum will likely require a minor reduction as well to allow better aesthetic balance between the bridge and tip. It should be noted that these changes require advanced techniques that should only be trusted to an experienced facial plastic surgeon who performs revision rhinoplasty on a frequent basis.
Helpful 1 person found this helpful
February 9, 2016
Answer: What is the best way to improve a retracted columella? This would be a revision surgery. Hi, I have performed and taught Rhinoplasty for over 30 years. From the photos, your nasal tip is over projected and under rotated. The under rotated nasal tip is responsible for hiding the columella that should have from 3 to 5 mm's of show on a profile view. The tip is also a bit wide. In this scenario, an Open Revision Tip-plasty would be able to thin the tip, decrease the projection and create the appropriate amount of upward tip rotation.Hope this helps.
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February 9, 2016
Answer: What is the best way to improve a retracted columella? This would be a revision surgery. Hi, I have performed and taught Rhinoplasty for over 30 years. From the photos, your nasal tip is over projected and under rotated. The under rotated nasal tip is responsible for hiding the columella that should have from 3 to 5 mm's of show on a profile view. The tip is also a bit wide. In this scenario, an Open Revision Tip-plasty would be able to thin the tip, decrease the projection and create the appropriate amount of upward tip rotation.Hope this helps.
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