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Is It Possible to Correct a Hanging Columella with a Closed Rhinoplasty?

asked 1 year ago by Miami3816 in Miami
Latest answer by Kevin F. Hagan, MD
Question viewed 1,385 times
Tags: columella, hanging

I have a "hanging columella" and never under went any procedure on my nose. i' m ok with my tip but my nostrils shows a lot on the side, my nose looks longer than it is but even if i am very unhappy with it i' m afraid to go through the next step surgery just because i don t know how complicated the intervention is and if it needs to be an opened rhinoplasty. Thank you!

20 answers to Is It Possible to Correct a Hanging Columella with a Closed Rhinoplasty?

Treating a hanging columella

Yes, a hanging columella can be treated with a closed approach, though an open approach can also be used if that's the surgeon's preference. I have found good success in treating an isolated hanging columella using the closed approach. The hanging columella can be caused by an excessively long septum in that area. Some will treat the problem by trimming the septum. I've also treated the problem by using what's called a tongue-in-groove technique where the cartilage... more

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Hanging columella

Yes! A hanging columella can be corrected with a closed approach. However, if you are concerned about the degree of your columella that shows, you and your surgeon must determine if the columella show is due to elongation of the columella or retracted ala. This is vitally important to determine the corrective steps that must be undertaken to correct this problem. I recommend consultation with an experienced rhinoplasty surgeon to evaluate the nose and determine what... more

P. Daniel Ward, MD
Salt Lake City Facial Plastic Surgeon

A hanging columella is easily corrected with a closed rhinoplasty.

A hanging columella can be easily corrected via the "closed" approach utilizing bilateral rim incisions that are virtually invisible once healed. It can be done under a local anesthesia without difficulty.

Kevin F. Hagan, MD
Nashville Plastic Surgeon

Hanging columella can be corrected by closed rhinoplasty

Trimming the membranous cartilaginous caudal septum can reduce the columellar show. This can be done quite easily through a closed rhinoplasty and is performed quite frequently in our practice.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Hanging Columella Can Be Fixed By An Endonasal Rhinoplasty Approach

The hanging columella is usually the result of a combination of a long caudal septum, a low hanging position of the medial footplates and excessive nasal mucosa. It can be repaired through either an open or closed approach depending upon the surgeon's preference. Given that you have no other nasal concerns, it would make the most sense to limit the extent of the surgery and recovery and use a closed approach. In reality, a closed approach means that the incisions are on the... more

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon

www.eppleyplasticsurgery.com

Hanging Columella

Hello, Although the hanging columella may be caused by many different anatomical variations, yours appears to be due to the cartilages that involve your entire nasal tip, known as the 'lower lateral cartilages'. In your situation, you have an accentuated curvature of the part of the cartilages below the tip but are also affecting the tip as well. Proper treatment for your cartilage would involve using internal sutures to rebend the cartilage complex into a... more

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon

Treating Hanging Columella with Endonasal (Closed) Rhinoplasty

Hi Miami3816, Yes, a hanging columella may treated via an endonasal or closed rhinoplasty. Hanging columella may be due to several factors such as excess tip cartilage, excess membrane tissue, excess septum, or excess bone. Rhinoplasty via an endonasal approach does not leave any external scars and generally has less swelling the open rhinoplasty approach. However, more important that the specific approach, open or closed, is the specific maneuvers during the rhinoplasty... more

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon

Is It Possible to Correct a Hanging Columella with a Closed Rhinoplasty?

First thanks for posting a photo. Yes in the closed rhinoplasty correction of the hanging columella can be done. See at least 3 opinions in person from boarded surgeons in MIAMI. Dr. Darryl J. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon

Treatment of the hanging columella

The hanging columella can be due to the caudal septum protruding, to wide lower lateral cartilages, to a hanging tip, to malposition of the alar bases, or to a combination of all of the above. Depending on the combination of problems, an open or closed rhinoplasty may be necessary. For simple versions of this problem, a closed rhinoplasty may certainly be sufficient.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

How to Correct Hanging Columella

Dear rhinoplasty patient from Miami, I reviewed your nasal picture. If hanging columella is what you’re concerned with, I would recommend a columallar elevation. This can be done by caudal septum (bottom of septum) resection and reattaching the columella to the septum. This procedure can be done in office setting with local anesthesia

Kevin Sadati, DO
Orange County Facial Plastic Surgeon

www.galleryofcosmeticsurgery.com

Tip and hanging columella go hand in hand

Most people focus on the hanging columella, which can easily be treated with a closed technique. It is important to look at the curve of the nostril. As we age, the cartilage softens and the rim of the nostril begins to retract, showing more of the columella. This process is often accelerated as portions of the upper cartilage is removed during a rhinoplasty to narrow the tip. For this reason I will commonly place a small piece of cartilage from the septum along the rim of the nostril to... more

Brian Maloney, MD
Atlanta Facial Plastic Surgeon

Hanging columella

Hello, It is possible to elevate the columella with a tongue and groove in a closed procedure. A nylon suture to the septum will elevate the columella. Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon

Haning columella can be imporved via closed approach

A "hanging columella" is noted when the central portion of the nose (between the nostrils) hangs more than 2-3mm below the nasal rim. This condition can be due to an elongated septum or large nasal spine. In either case, it is relatively easy to fix this without performing an incision across the columella (open rhinoplasty). This procedure could potentially be done under local anesthesia. The surgery would involve partial removal of the anterior septum or nasal spine and... more

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon

facialplasticsurgerymd.com

Correcting The Hanging Columella With Open Rhinoplasty

The hanging columella is a condition which can usually be corrected via a closed rhinoplasty approach. Although different situations may lead to excess columellar show, a common cause of hanging columella is excess caudal septum. The septum is the cartilage and boney wall which separates the nostrils. If there is excess caudal septum, the cartilage can cause the columella to protrude. The septum can be shaves with a closed rhinoplasty technique, and can then... more

Anthony Corrado, DO
Philadelphia Facial Plastic Surgeon

Correcting a hanging columella

If a hanging columella poses concerns, it is possible to raise the columella with a closed rhinoplasty approach. The decision to complete nasal shaping with an open or a closed approach depends on what is required to shape the tip, contour the bridge, and place any supporting grafts if needed. If the columella is your only issue, the closed rhinoplasty should be right for you. Best of luck, peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon

A hanging columella is not always recognized in rhinoplasty

A hanging columella is when the area between the two nostrils hangs downward showing too much skin on profile. This can also make a nose look too long. According to the medical literature, the columella should not hang more than 2 to 4 millimeters below the edge of the nostrils when viewed on profile. There are a number of ways to treat or reduce a hanging columella, the technique used really depends on the actual cause; which can vary. I treat hanging columellas through and endo-nasal... more

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

In my practice, a hanging columella is best repaired with Rhinoplasty Surgery using an open approach.

I read your concern and reviewed your photo. The best way to repair a hanging columella is to determine the cause. It may be due to your septum being too long. I suspect, in your case, the exaggerated curvature of your columella will require division of your lower lateral cartilages to straighten the medial crurae. You might also benefit from a columella-strut, cartilage graft for additional straightening. In my practice, an open approach would be used. I hope this is helpful for you. more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Closed Rhinoplasty

Most rhinoplasties can be performed closed (incisions inside the nose). However, every surgeon is different and you will need to discuss your specific case with your surgeon. Good luck.

David Shafer, MD
New York Plastic Surgeon

Hanging columella treatment.

For the past 35 years I have treated the hanging columella like yours closed even though I was one of the pioneers of open rhinoplasty. when . In those says almost all surgeons did noses closed and I was considered a heretic.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Hanging columella treatment

Treatment if a hanging columella can be done with a closed or open approach depending upon what else needs to be done. If it is just an isolated hanging columella, then it can all be done "closed."