Is it normal for the columella to be sewn completely flat so that it doesn't show at all from the profile?

Question

My nose tip also seems very pointy and overprojected and upturned. I wanted a slightly rounded tip. I am 3 weeks out from a revision rhinoplasty with septum and ear graft to derotate and lengthen the nose that was overresected. I know I must have swelling left, but my nose seems too defined and pointy and I am especially really worried about the complete flatness of the columella, which exaggerates the miss piggy look from the upturned tip.

Sam P. Most, MD · Answer

Sorry to hear about your
concerns.  While it is impossible to tell with certainty from photos
without a personal consultation, it is unlikely your nose will become 'less pointy' as time goes on, or that the columella would show more.  You should address your concerns with your surgeon.

If you cannot do so, you should seek an experienced revision surgeon and bring your
old photos and operative notes.  But it would really take 9-12 months before such a consultation would be useful, as things would continue to change over that time.I hope this helps you.Best,Dr. Most

Michael Elam, MD (retired) · Answer

Dear sciarpa, No, it is not normal for the columella to be sewn flat as it is an integral part of the nose and it's multiple dimensions. The nasal anatomy has to be taken into consideration in all of it's complexity at the time of surgery.  With all of this said, your surgeon is your best advice at this time and can walk you through this process of recovery. You are three weeks post op and will go through different stages of recovery and if you have any concerns then ask your surgeon for a referral and seek a second opinion. If you go through this process and still seem concerned then you will be ready to seek opinions from multiple experts for a possible revision procedure. Best regards, Michael V. Elam, M.D.

Is it normal for the columella to be sewn completely flat so that it doesn't show at all from the profile?

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