Hanging Columella Reduction Under Local Anesthesia

Looking at the one photo provided, it does appear that you have a hanging columella and a wide nasal base. Without seeing other views, it is somewhat difficult to determine what would be best in terms of a revision rhinoplasty procedure. Strictly speaking, the hanging columella can be addressed successfully under local anesthesia. This involves injecting an anesthetic solution in and around the bottom of the nose. The columella can then be approached with an incision made along both sides with subsequent adjustments made through this approach. Make sure you consult with a revision rhinoplasty specialist who has photos of other patients they have done using this technique. Good luck.

I read your concern, and I reviewed the photo you posted. You may require revision rhinoplasty performed with general anestheitc to prevent your columella from hooking down when you smile. I doubt you would get significant improvement by having only your septum reduced under local anesthetic.

You'll likely need to have your tip supported with a cartilage graft (C-strut), and have your lower lateral cartilages divided to allow your columella to rise up. Septal shortening may be performed at the same operation.

All the best from NJ.