Hanging Columella Swelling 4 Months After Open Rhinoplasty, Is This Likely to Change?

Question

Hi there, I had an open rhinoplasty(correction of all bony and cartliaginous elements) and septoplasty (deviated septum and turbinate reduction) done 4 months ago. My tip and columella look big. I was really happy when I saw my nose after the cast was taken off, but now I'm a bit worried. My columella looked ok first week after the surgery but now it appears to be hanging.I am really concerned about this and would appreciate if you could advise me on my concern.

Ronald Schuster, MD · Answer

After 4 months I do not think that your columella is going to rise, sorry to say. The rest of your nose looks great so maybe it wasn't apparent at the time of the surgery, or maybe a suture broke. In any case if it remains like that a revision to lift it should be pretty easy. Just diiscuss it calmly at your next visit with your surgeon. He/she will want you to be happy and I suspect will help you. Be prepared to wait until 6-12 months after surgery before doing any further touch up. Often it is not a good idea to go back too soon as there is still too much healing and swellin to be acurate. Good luck.

Eric M. Joseph, MD · Answer

Thank you so much for sharing your photos.  Your hanging columella appears to be multifactorial: You can see nostril retraction along with an exaggerated curvature of your columella that is leading to your excessive nostril-show on profile.

Before considering further surgery, you may consider a possible injectable filler treatment to your nostril margins to try to lower these. You should consult a surgeon experienced in the delicate art of using fillers in your nose. We prefer to use Silikon-1000, an off-label filler for permanent results.

You may ultimately require revision surgery to straighten your curved columella - consider consulting with another rhinoplasty specialist so you could see what might be best for you.Hope this helps. Dr Joseph

David A. Bray, Sr., MD · Answer

When an open rhinoplasty is done the incision is near the base of the columella> this effectively traps the normal lymph flow, the subsequent swelling will cause the hanging columella effect. Wait at least two more months and then judge.

Louise Ferland, MD (retired) · Answer

Your columellar show can certainly change as healing continues.  Healing takes longer in a open rhinoplasty and does not occur at the same speed through out the nose.  Edema can certainly be the main issue for the present appearance.  Be patient.  Sometimes unexpected scar tissue prevents the natural shrinkage of different areas of the nose after open rhinoplasty but scar tissue can be easily corrected.  Your surgeon will know when and if you might need a little touch up.  Best wishes.

Hanging Columella Swelling 4 Months After Open Rhinoplasty, Is This Likely to Change?

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Hanging Columella Swelling 4 Months After Open Rhinoplasty, Is This Likely to Change?

Answers (4)

Answer: Hanging columella after open rhinoplasty

Answer: Hanging columella after open rhinoplasty

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Everything you need to know about Rhinoplasty

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