Alar retraction, hanging columella, high radix or...?

Question

I had tip Rhinoplasty several years ago. “Lower lateral cartilage freed via inter cartilaginous incision, and narrow strip of caudal septum resected via columella incision” -according to primary surgeons notes. Revision Rhinoplasty: main concern is the ala retraction on the right side. Expensive & difficult to correct? Is bringing down the ala crease diagonally (towards the corner of mouth) an option? Any other suggestions? Thank you for you input and time.

William Portuese, MD · Answer

A revision rhinoplasty would be required to reduce the hanging columella and reduce the high radix. If you're going to reduce the high radix, this will involve re-doing the entire bridge line which may be counterproductive. The columella-plasty should be very straightforward and easy to accomplish by an experienced rhinoplasty surgeon. No alar retraction is present.

Richard W. Fleming, MD (retired) · Answer

I agree that your nose can be improved by reducing the radix, lowering the alar rim and raising the hanging columella. Consult with a revision rhinoplasty specialist who can show you multiple examples of results in patients who had problems like yours.

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