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My Son Has A Very Short Columella. Will It Grow

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Posted on Fri, 4 Oct 2019
Question: my son has a very short columella. will it grow and become less short?
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Follow up: Dr. Dr. Antoneta Zotaj (0 minute later)
my son has a very short columella. will it grow and become less short?
doctor
Answered by Dr. Dr. Antoneta Zotaj (1 hour later)
Brief Answer:
Nose size and shape change in the first two decades of life, based on genetics. Very likely your son will have some degree of short columella when grown-up

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

I carefully read your query and also checked the uploaded images.

The nose in children changes shape and size in the first 1-2 decades of life. The short columella, in this case, is a congenital condition (from birth) and in the first 10-15 years of your son's life the nose will change and get the final size and shape that is determined by the genetic background.
So, it is difficult to know for sure how much this condition will change but it is very likely that he will continue to have some degree of short columella when he is an adult.

Generally, the short columella is no source of concern other than the cosmetic side of it. If one is not happy with the size and shape, rhinoplasty (a surgery to repair the shape/size of the nose) can be done. This is generally not conducted before age 15 (some prefer to have it after the age of 20) because of the potential changes that may happen with age.

To conclude:
- the short columella is a genetic feature in your son (as it is from birth).
- it is not worrisome but the esthetic side (sometimes some patients do not prefer this shape of the nose, for some it is attractive)
- Your son will definitely have changes in the shape and size of his nose in the next 15 years. It is difficult to tell for sure how much these changes will be as the genes will determine the final look of his nose. Very likely he will have features of the short columella
- after age 15, when the final characteristics are developed, a further need for rhinoplasty can be decided.
- also, it is important that the child is well examined by the doctor to make sure that the nasal bones, palate (the roof of the mouth) and maxillary bones are normal and no other abnormalities are present.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Dr. Antoneta Zotaj (0 minute later)
Brief Answer:
Nose size and shape change in the first two decades of life, based on genetics. Very likely your son will have some degree of short columella when grown-up

Detailed Answer:
Hello and welcome to "Ask a Doctor" service,

I carefully read your query and also checked the uploaded images.

The nose in children changes shape and size in the first 1-2 decades of life. The short columella, in this case, is a congenital condition (from birth) and in the first 10-15 years of your son's life the nose will change and get the final size and shape that is determined by the genetic background.
So, it is difficult to know for sure how much this condition will change but it is very likely that he will continue to have some degree of short columella when he is an adult.

Generally, the short columella is no source of concern other than the cosmetic side of it. If one is not happy with the size and shape, rhinoplasty (a surgery to repair the shape/size of the nose) can be done. This is generally not conducted before age 15 (some prefer to have it after the age of 20) because of the potential changes that may happen with age.

To conclude:
- the short columella is a genetic feature in your son (as it is from birth).
- it is not worrisome but the esthetic side (sometimes some patients do not prefer this shape of the nose, for some it is attractive)
- Your son will definitely have changes in the shape and size of his nose in the next 15 years. It is difficult to tell for sure how much these changes will be as the genes will determine the final look of his nose. Very likely he will have features of the short columella
- after age 15, when the final characteristics are developed, a further need for rhinoplasty can be decided.
- also, it is important that the child is well examined by the doctor to make sure that the nasal bones, palate (the roof of the mouth) and maxillary bones are normal and no other abnormalities are present.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (2 hours later)
Thank you for your answer.
Me and my husband don’t have short columella. Do you think that a alcohol prenatal exposure can be the cause of this short columella?
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Follow up: Dr. Dr. Antoneta Zotaj (0 minute later)
Thank you for your answer.
Me and my husband don’t have short columella. Do you think that a alcohol prenatal exposure can be the cause of this short columella?
doctor
Answered by Dr. Dr. Antoneta Zotaj (14 minutes later)
Brief Answer:
Prenatal exposure to alcohol causes some other features that are not present in your son- details below

Detailed Answer:
Hello and welcome back,

I understand your concern with Fetal-Alcohol-Syndrome as no amount of alcohol is safe during pregnancy.
On the other hand, even though alcohol may cause a short nose in newborns, it also causes very thin upper lip and flattened philtrum (the groove between the nose and the upper lip).

I checked the pictures again and your son seems to have a full upper lip and the philtrum well developed so he does not seem to have the typical face of Fetal-Alcohol-Syndrome. Your son is a beautiful little boy.

As for genetics, even though neither you or your husband have short columella, it may be a finding in some family of either of you and sometimes we are not aware.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Antoneta Zotaj (0 minute later)
Brief Answer:
Prenatal exposure to alcohol causes some other features that are not present in your son- details below

Detailed Answer:
Hello and welcome back,

I understand your concern with Fetal-Alcohol-Syndrome as no amount of alcohol is safe during pregnancy.
On the other hand, even though alcohol may cause a short nose in newborns, it also causes very thin upper lip and flattened philtrum (the groove between the nose and the upper lip).

I checked the pictures again and your son seems to have a full upper lip and the philtrum well developed so he does not seem to have the typical face of Fetal-Alcohol-Syndrome. Your son is a beautiful little boy.

As for genetics, even though neither you or your husband have short columella, it may be a finding in some family of either of you and sometimes we are not aware.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (46 hours later)
Thank you.
I would like to ask one more question.
And about the retraction? Do you also think that his columella is retracted?
Have you ever seen retracted columella in babies? Does it become less retracted?
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Follow up: Dr. Dr. Antoneta Zotaj (0 minute later)
Thank you.
I would like to ask one more question.
And about the retraction? Do you also think that his columella is retracted?
Have you ever seen retracted columella in babies? Does it become less retracted?
doctor
Answered by Dr. Dr. Antoneta Zotaj (3 hours later)
Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

It is very common for children to have a short nose with the impression of retracted columella soon after birth and the first few years of life. This is especially due to the fact that the nose, especially the bones that make the major supportive structure of the nose, have not developed as yet.

I have had patients with a similar nose shape as your son, but with the development of the nose and while the bridge of the nose gets more prominent these features gradually fade.
In the case of your son, as I mentioned, it will depend on genetics, which is the final shape his nose will have.

By watching the pictures, his columella seems a bit short and the nose-tip is a little upward, but this finding is quite common among newborns. In my opinion, his nose looks nice and there is nothing to worry about it.

Furthermore, I would expect it to become less retracted with age especially if you do not have the genetic background for a retracted columella.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Dr. Antoneta Zotaj (0 minute later)
Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

It is very common for children to have a short nose with the impression of retracted columella soon after birth and the first few years of life. This is especially due to the fact that the nose, especially the bones that make the major supportive structure of the nose, have not developed as yet.

I have had patients with a similar nose shape as your son, but with the development of the nose and while the bridge of the nose gets more prominent these features gradually fade.
In the case of your son, as I mentioned, it will depend on genetics, which is the final shape his nose will have.

By watching the pictures, his columella seems a bit short and the nose-tip is a little upward, but this finding is quite common among newborns. In my opinion, his nose looks nice and there is nothing to worry about it.

Furthermore, I would expect it to become less retracted with age especially if you do not have the genetic background for a retracted columella.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Dr. Antoneta Zotaj (23 hours later)
Thank you very much for your patience and detailed answers.
Sorry for so many messages. I will try to explain why I am so anxious.

I read a publication about effects of prenatal alcohol exposure in JAMA called : “Association Between Prenatal Alcohol Exposure and Craniofacial Shape of Children at 12 Months of Age” And this study shows that: “Results indicate a mild midfacial recession suggestive of subclinical hypoplasia and an upturning of the nasal tip in those exposed to alcohol prenatally. This phenotype was evident even when drinking was at a low level and mothers ceased alcohol consumption in the first trimester.” “Our study has examined the association of low levels of PAE using a more rigorous assessment of both face shape and alcohol consumption. We show that certain aspects of the phenotype (upturning of the nasal tip and midfacial hypoplasia) can be detected even when the maximum number of standard drinks (10 g of AA) did not exceed 7 per week and 2 per occasion. We did not observe the classic diagnostic features for FAS of smooth philtrum, reduced palpebral fissure length, and thin vermillion of the upper lip; it is likely that these features emerge only at higher levels of exposure.”

I also read that facial features can occur only if mother drink during the period of gastrulation.
And I drunk three sips of wine once probably in this period (before I knew I was pregnant). And now my son has a variation exactly in the same structure that is mentioned in the article for light drinking.
So I am in doubt if this variation was caused by alcohol. I know he doesn’t have the sentinels features, but this study refers subtle features with light drinking.
I know I have been boring you and I am really sorry. I am not this kind of person, but I am trying to understant this.
default
Follow up: Dr. Dr. Antoneta Zotaj (0 minute later)
Thank you very much for your patience and detailed answers.
Sorry for so many messages. I will try to explain why I am so anxious.

I read a publication about effects of prenatal alcohol exposure in JAMA called : “Association Between Prenatal Alcohol Exposure and Craniofacial Shape of Children at 12 Months of Age” And this study shows that: “Results indicate a mild midfacial recession suggestive of subclinical hypoplasia and an upturning of the nasal tip in those exposed to alcohol prenatally. This phenotype was evident even when drinking was at a low level and mothers ceased alcohol consumption in the first trimester.” “Our study has examined the association of low levels of PAE using a more rigorous assessment of both face shape and alcohol consumption. We show that certain aspects of the phenotype (upturning of the nasal tip and midfacial hypoplasia) can be detected even when the maximum number of standard drinks (10 g of AA) did not exceed 7 per week and 2 per occasion. We did not observe the classic diagnostic features for FAS of smooth philtrum, reduced palpebral fissure length, and thin vermillion of the upper lip; it is likely that these features emerge only at higher levels of exposure.”

I also read that facial features can occur only if mother drink during the period of gastrulation.
And I drunk three sips of wine once probably in this period (before I knew I was pregnant). And now my son has a variation exactly in the same structure that is mentioned in the article for light drinking.
So I am in doubt if this variation was caused by alcohol. I know he doesn’t have the sentinels features, but this study refers subtle features with light drinking.
I know I have been boring you and I am really sorry. I am not this kind of person, but I am trying to understant this.
doctor
Answered by Dr. Dr. Antoneta Zotaj (1 hour later)
Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

I carefully read your query and the information provided. I am not bothered at all, it is my pleasure to assist you, so please feel free to let me know if you have any concerns. I am sorry you are having these concerns and I hope my answer will reassure you.

As I mentioned in the first email, there is no amount of alcohol that is considered safe during pregnancy so I understand the concern you have that the small amount of wine you may have had during the time you did not know you were pregnant may have affected your child.

The study mentions that these minor changes were noticed in those that had a small amount of alcohol on the other side the study says that more studies should be done to confirm this theory.

So, in all, it is difficult to know for sure if the face characteristics in your son are his normal variation or due to alcohol. He certainly does not have the full picture of fetal alcohol syndrome and does not fulfill the criteria for this diagnosis.

It is important that you do not feel guilty or condemn yourself related to this. First of all, there is no way at the moment to confirm if these features are a variation of the norm in him or due to alcohol. Secondly, he does not seem to have serious deformities or organ problems. And lastly, this consumption was unintentional.

To conclude:
- it is difficult to know for sure if this is a variation of the norm or due to the small amount of wine you used (as the features are very mild)
- it is important to not blame yourself
- it is also important to consider that he does not seem to have serious or worrisome findings. He very likely will live a healthy life that will not be affected by this.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Dr. Antoneta Zotaj (0 minute later)
Brief Answer:
Detailed answer below

Detailed Answer:
Hello and welcome back,

I carefully read your query and the information provided. I am not bothered at all, it is my pleasure to assist you, so please feel free to let me know if you have any concerns. I am sorry you are having these concerns and I hope my answer will reassure you.

As I mentioned in the first email, there is no amount of alcohol that is considered safe during pregnancy so I understand the concern you have that the small amount of wine you may have had during the time you did not know you were pregnant may have affected your child.

The study mentions that these minor changes were noticed in those that had a small amount of alcohol on the other side the study says that more studies should be done to confirm this theory.

So, in all, it is difficult to know for sure if the face characteristics in your son are his normal variation or due to alcohol. He certainly does not have the full picture of fetal alcohol syndrome and does not fulfill the criteria for this diagnosis.

It is important that you do not feel guilty or condemn yourself related to this. First of all, there is no way at the moment to confirm if these features are a variation of the norm in him or due to alcohol. Secondly, he does not seem to have serious deformities or organ problems. And lastly, this consumption was unintentional.

To conclude:
- it is difficult to know for sure if this is a variation of the norm or due to the small amount of wine you used (as the features are very mild)
- it is important to not blame yourself
- it is also important to consider that he does not seem to have serious or worrisome findings. He very likely will live a healthy life that will not be affected by this.

I hope this answers your query. I remain at your disposal in case further medical assistance is needed.

Regards,
Dr. Antoneta Zotaj
General and Family Physician

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Dr. Antoneta Zotaj

General & Family Physician

Practicing since :2004

Answered : 4435 Questions

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My Son Has A Very Short Columella. Will It Grow

my son has a very short columella. will it grow and become less short?