You have a dependent tip which can be supported by a columella strut or by riding your medial crura on the caudal septum (Fred technique) which at the same time will eliminate the ill effects of the DSM, reduce hanging columella and tip and elongate the upper lip. If a columella strut is used the caudal septum has to be shortened to avoid protrusiton of the of the columella.
I perform these maneuvers through a closed approach every week. You will need the osteotomies after the hump reduction. The spine is reduced. Find a rhinoplasty expert who creates natural results.
Kenneth Hughes, MD
Los Angeles, CA