A Clicking Sound When I Push the Columella After Implant Removal — Is It the Septal Cartilage Knocking?

01

What was the question?

It came from someone about 3 years out from removing the tip cartilage (donor rib cartilage) and silicone and having cartilage repositioning surgery. The implant removal was done at another clinic, and out of caution they had avoided even touching the nose for about a year after surgery.

The sound began about a year after surgery. Holding the columella area and pushing the septum to the right as if pushing it aside produced a click; pushing left produced none. When the sound occurs, it feels like bone knocking against bone — a small something being touched — but it returns right away afterward.

When they visited a clinic out of concern, they heard two explanations: that a weak support may have left an area of severe adhesion unremoved, and that this kind of sound can occur even in people who never had nose surgery. Still, a click sometimes sounds from the nose when laughing widely — making them avoid laughing hard — and they also asked about a throbbing pain at times near the alar cartilage beside the columella inside the nostril that subsides when gently pushed to the right.

02

What causes this sound?

A sound that appears when laughing widely, when the muscles around the nose pull, or when the columella is moved by hand may be related to cartilage movement. Still, the cause and harmlessness cannot be confirmed without looking at the surgical record and current structure.

Summarizing, the situations where the sound occurs divide as follows.

• When pushing the columella by hand — since it is the act of directly moving the septum by hand, cartilage can knock and produce sound.
• When laughing widely — a situation where the muscles around the nose pull hard, so sound can occur in the same way.
• When it returns right away after the sound — if it goes back to normal after sounding, it can be read as a sound of the knocking moment.

Looking at the situation the sound occurs in together with what changes afterward helps distinguish what kind of sound it is. By what criteria the state after a previous surgery is judged can be seen in more detail in the revision surgery guide.

03

Summary — look at the situation the sound occurs in first

A click after implant removal and cartilage repositioning may relate to cartilage movement, but it cannot be confirmed remotely. Do not repeatedly push the columella to check; if new pain, deformation, or breathing change appears, or the sound grows more frequent, have the surgical record and current structure examined in consultation.