How can a retracted columella that resulted from a rhinoplasty be fixed? (photos)

Question

I have read septum or rib should be used, but what if septum or a rib is not available for use? 1) What else can be used? 2) Can this be done closed rhinoplasty revision? 3) Why does retraction occur in the first place? 4) The bottom of my nose is very flat. I am missing middle part of my nose from front view & tip from side view. Is that because of retracted columella or something else?

Tanveer Janjua, MD · Answer

This can be accomplished with any source of cartilage;
Septum
Ear
Rib
Cadaveric rib
Lower lateral cartilages
Can be done under local. 
Regards
Dr. J

Celal Alioglu, MD · Answer

Hello I need to see your nose in real but you will need to use cartilage because your septum very small

Jonathan Kulbersh, MD · Answer

Hello, and thank you for your question. Based on the photos you provided, you do appear to have a retracted columella. To correct this, a surgeon can lengthen the columella and septum by placing a cartilage graft –either through rib and septal cartilage or one taken from the ear.

To best determine the right surgical approach for your case, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon, particularly one with a strong rhinoplasty portfolio. Your surgeon can do a proper evaluation of your nose, determine your eligibility for revision rhinoplasty, recommend the best surgical technique, and ensure the best possible outcome. Keep in mind that secondary rhinoplasty is even more complex than primary rhinoplasty.

Edwin Kwon, MD, FACS · Answer

It appears from the photos that you have a slightly retruded columella.  I'm not sure whether your columella was slightly retruded even before surgery or whether you had significant retraction of the columella after your surgery.

A retruded columella can usually be addressed with grafts on the columella to help "volumize" this area.  However, I have found that it does not provide complete resolution, but tends to improve the retruded columella enough.

Robert Ciardullo, MD · Answer

Fixing a retracted Columella: from the pictures you show, you do appear to have a retracted columella. The treatment for this would generally involve a cartilage graft. if rib and septal Cartlidge has already been used up sometimes Cartlidge taken from the ear is used. Cadaver Cartlidge could also be used. The procedure can be done open or closed.

How can a retracted columella that resulted from a rhinoplasty be fixed? (photos)

Answers (5)

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