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I Don't Like the Tip of my Nose. I Think I Have a Hanging Columella and Retracted Nostrils. What Do You Suggest? (photo)

asked 5 months ago by calmlotus1 in los angeles, CA
Latest answer by William Portuese, MD
Question viewed 395 times
Tags: nostrils, columella, hanging, options, retraction

I don't like the tip of my nose. I think I have a hanging columella and retracted nostrils. I would like a softer feminine nose. What do you suggest?

11 answers to I Don't Like the Tip of my Nose. I Think I Have a Hanging Columella and Retracted Nostrils. What Do You Suggest? (photo)

+1

Hanging Columella and Retracted Nostrils

I agree that you do have a hanging columella and retracted nostrils which can be corrected by elevating the columella and placing cartilage grafts to lower the nostril margins. Although it is difficult to determine with the pictures submitted, the tip can be refined by decreasing the width and adding a small graft to increase projection and define the tip. See a rhinoplasty specialist to examine you, present alternatives, and establish reasonable expectations.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

+3

I Think I Have a Hanging Columella and Retracted Nostrils

Thank you for your question. From your photographs it is very difficult to evaluate your nose adequately enough to give you a meaningful answer. It does seem that the tip is a little bulbous however you would need a true lateral (side) view to determine whether you have a hanging columella and retracted nostrils. I would strongly suggest that you see ether a board certified plastic surgeon or a facial plastic surgeon and have them examine your nose both externally and... more
Donald M. Brown, MD

San Francisco Plastic Surgeon
+1

Treating hanging columella & retracted nostrils

Hanging columella is treated by removal of both skin and cartilage on the columella to tuck in the columella. Alar retraction is treated best with composite skin grafts composed of both cartilage and skin taken from the ear and placed up on the inside of the nostrils to bring the alar rims down and improve nostril notching.
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Nostrils and hanging columella

It is difficult to evaluate your nose with the photos you posted. Certainly if you have a hanging columella or retracted nostrils these things often can be addressed with rhinoplasty.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Retracted Alar rim vs Hanging Columella

Based on your picture one alar rim seems to be a bit more retracted up than the other. The columella doesn't look too bad but the pictures don't allow for a proper analysis.
Karol A. Gutowski, MD

Chicago Plastic Surgeon
+1

Rhinoplasty and droopy tip

It is impossible to say what needs to be done without an in-person examination. However, from the photos shown, there is apparent alar retraction and a hanging columella. These can be treated with a variety of methods including cartilage grafts to the alar rims and careful reduction of the columella, if possible. Make sure your surgeon is a Board-Certified expert in rhinoplasty. Good luck!
David Alessi, MD

Beverly Hills Facial Plastic Surgeon
+1

Rhinoplasty

One can have a hanging columella, retracted nostril rims or both. It is important to assess/diagnosis this before surgery in order to plan surgery appropriately and avoid making things worse. Because none of your posted photos is a true side view I cannot tell from the photos exactly which applies to your case, although the first photo likes like the nostril rim may be retracted. The way to assess this is on a side view where the nostril rim to outer surface of columella distance should be... more
Aaron Stone, MD

Los Angeles Plastic Surgeon
+1

I Don't Like the Tip of my Nose. I Think I Have a Hanging Columella and Retracted Nostrils. What Do You Suggest?

I have performed Rhinoplasty for over 2 decades and your nose has neither a hanging Columella nor retracted nostrils. The nasal tip is a bit wide, with thick skin and is under rotated. The tip could be refined with a Closed Rhinoplasty.
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon
+1

Improving the alar columellar relationship

From your photos, it appears that the nostril retraction is a bigger issue, but it needs to be seen in person. Your cartilage is shaped in a way that predisposes you to this and you would need cartilage grafting and repositioning to help improve the shape of your nose and strengthen the alar/nostril rims. If you undergo a rhinoplasty without cartilage grafting, it is likely you will see a worsening of the retraction. See a surgeon experienced in nasal surgery to get a formal... more
Vincent P. Marin, MD

San Diego Plastic Surgeon
+1

Hanging

I think most of your problem is the retracted alar rims. Cartilage grafts are the way to correct this but, select an experienced surgeon. This not a routine provcedure
David A. Bray, Sr., MD

Los Angeles Facial Plastic Surgeon
+1

Reshaping Nostrils and Treating Hanging Columella

Nostril or "alar reshaping" is a procedure I have performed in my practice for many years. The first article I wrote on the topic appeared in the journal of Plastic and Reconstructive Surgery in 1987. More recently I wrote a review article in the Journal of Aesthetic Surgery in 2002. There are a number of ways nostrils can be reshaped with incisions on the inside of the nostrils and with cartilage grafts. In addition, through a "closed rhinoplasty" technique, a hanging... more
Richard Ellenbogen, MD

Los Angeles Plastic Surgeon

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