If the Columella Looks Dented 1 Year 6 Months After Rhinoplasty — The Order for Judging Whether It's a Side Effect or Needs Revision
2025. 9. 3.
When the columella (between the nostrils) looks dented 1 year 6 months after rhinoplasty — how to distinguish whether it's the incision site sinking in, the original structure, or a side effect, plus criteria for considering partial revision, organized through a consultation case.
Key points
- Possible causes of the columella (between the nostrils) looking dented include the original structure, incision scarring, soft-tissue change, inflammation, and more.
- Whether it's a side effect or the original structure can only be known by comparing with preoperative photos — it can't be judged from appearance alone.
- Revision scope is set after confirming the cause of the dent and whether it's connected to tip support structures — we don't promise in advance that the columella alone can be fixed.
The nose sits at the center of the face and greatly affects impression and image. Because even small changes shift the overall mood, many people deliberate carefully and consider both functional aspects and aesthetic results ahead of surgery. In consultation, realistically explaining possible postoperative side effects is important — it improves understanding and satisfaction with results and reduces unnecessary worry.
Based on a real inquiry, this article organizes the changes that can appear after rhinoplasty and the order for judging whether revision is needed.
01
What was the concern?
The consultation went like this.
> It's been about 1 year 6 months since my rhinoplasty. The bridge was raised with silicone and an implant was placed in the tip too. It was fine right after surgery, but over time I've noticed the area between my nostrils — which should run straight — looks like a dented mark. I'm satisfied with the bridge line, but I don't like the tip shape and I'm wondering whether I should consider revision.
The bridge is fine and only the columella (nasal pillar) area bothers them — a localized concern. In cases like this, there are things to check before deciding whether the whole nose needs revision.
02
What causes the columella to look dented?
From photos alone, you can't tell whether it's the incision scar from surgery, the original structure, or soft-tissue change/inflammation. Pre- and post-operative photos, surgical records, palpation, and wound state must be checked together.
Causes of the sunken appearance get sorted into three possibilities:
- A structure that was always there — if the same shape existed before surgery, it may not be a change caused by surgery.
- Change at the incision site — the area incised during surgery appears sunken.
- Localized inflammation or scarring — localized inflammation or scarring remaining only in the columella may have altered the tip shape.
Which it is can't be decided from appearance alone — a precise examination is needed.
03
What determines whether revision is needed?
| What to check | Why it matters |
|---|---|
| Pre-op photos & records | The criterion for distinguishing original structure from post-surgical change |
| Time elapsed since surgery | Check whether change is ongoing and the state of scarring, inflammation, tip support |
| Extent of satisfactory areas | Check whether the area to preserve is structurally connected to the cause of the dent |
Whether to revise is judged after comparing preoperative records with the current state together. Check first with the operating clinic if it holds the records — but if the explanation is insufficient or infection or wound problems are suspected, a direct evaluation from another revision-rhinoplasty team is also possible.
General criteria for judging revision are covered in more detail in the revision guide.
04
Summary — confirming the cause comes before deciding on revision
A dented-looking columella easily starts from "should I revise or not," but the correct order is confirming the cause first. Whether it's the original structure, a change at the incision site, or localized inflammation/scarring changes what action is needed — and if there's a satisfactory area like the bridge, the revision scope can narrow accordingly. That's why consultation with a team that holds the preoperative records is the first step.
If you have a similar concern, your current state can be assessed in a 1:1 video consultation. Actual revision cases can be seen in before & after photos.
Frequently asked questions
Answers to common questions patients ask before a consultation.
If the area between the nostrils looks dented, is it a side effect?
I like the bridge — does revision mean redoing everything?
It's been 1 year 6 months — will waiting longer change anything?
Responses to treatment and recovery progress vary by individual. Outcomes and side effects vary from person to person. Bleeding, infection, swelling and asymmetry may occur. Please consult our medical team before making a decision.