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Is It Common And/or Simple to Bring Down Columella?

My surgeon says that he will bring down my columella slightly. Currently from the side you cannot really see my columella at all, which I don't like but previously didn't know WHAT I didn't like about it...it just looks rather unnatural. It will look MUCH better if it is slightly lower. Anyway, I can't seem to find any other cases where a patient had their columella brought down. Is this an uncommon thing to do?

Doctor Answers (9)

Lowering the columella

+1

It is much more common to bring the columella up than it is down.  To bring the columella up trimming of the caudal septum of both cartilage and membrane is performed to trim back the columella.  To give more columellar show, a cartilage graft is inserted in the columellar area from the septum to augment and bring forth the columella.  This can easily be performed at the time of the rhinoplasty.


Seattle Facial Plastic Surgeon
5.0 out of 5 stars 54 reviews

Increasing Columellar Profile Show In Rhinoplasty

+1

It is not common to drop down the columella in many rhinoplasties, but it can be done by cartilage grafting. Several millimeters of increased columnellar profile can be obtained by either a septal extension graft or an interpositional medial footplate graft. 

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 26 reviews

Columella surgery

+1

It is simpler to raise a columella that hangs down than to do the opposite which is what I think you are describing.  Is this the result of previous surgery? To me, it doesn't seem like it's worth undergoing in either case, but it would be helpful to see photos.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 7 reviews

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Improving nasal profile

+1

A photograph would be very helpful in determining your specific nasal profile.  If the columella is retracted then is is common to have a somewhat  underprojected nasal tip or a drooping nasal tip.  There are several surgical maneuvers  that can be done to improve your nasal profile

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 7 reviews

Columella retraction

+1

Not seeing the columella a bit in profile may be due to one of several reasons.  It is best to go for a consult to be properly evaluated.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

It Is Common To Bring Down The Columella Of The Nose

+1

  From the side, it is an elegant appearance to see 2-4 mm of the columella.  In patients that cannot see the columella from the side, it is either due to:

1)  The columella is retracted or short

2)  The nostril is low or hanging

This can be corrected either surgically or non-surgically.

 

Surgically, to bring down the columella, I use a septal extension graft with a PDS plate.  This is medically terminology to bring down the columella by making the septum longer in the area.  If the nostrils are low or hanging, then they can made raised by removing a small amount of tissue inside of the nose.

 

The columella can be make lower non-surgically by placement of temporary injectable fillers.  The nostrils cannot be raised using non-surgical techniques

 

I hope this helps!

Jonathan Kulbersh, MD
Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Non-surgical rhinoplasty may improve the columella with fillers

+1
  • I really like using fillers to increase the columella show from the profile. 
  • The goal is to have 2-4 mm of show on profile.
  • You can also ask your provider to do a test injection with saline to show you how it will look.

 

David Mabrie, MD
Bay Area Facial Plastic Surgeon
4.5 out of 5 stars 54 reviews

Columella lowering

+1

This is common in black noses and less so in Caucasians. Cartilage grafts or composite grafts are used to do this. I need photos to give u a better answer. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Rhinoplasty changes in columella

+1

Dear maeby,

  • Placing a graft in the columella will make it come lower
  • There are also ways to lift the nostril to show more of the columella

Best regards,

Nima Shemirani

Nima Shemirani, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.