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Should I Go for Revision Rhinoplasty Because of Hanging Columella?

I had a Rhinoplasty operation 2 years ago and was quite happy with the results at the time, but since then I have grown increasingly unhappy with the tip. I think it looks quite bulbous due to hanging columella. What is your opinion? And if necessary, how easy would it be to correct? (I can't upload my image as it's a pdf - I could email it to you if you respond? Thanks!)

Doctor Answers (33)

Hanging columella: a good reason for revisional surgery

+2

I just think a hanging columella is a hallmark of bad rhinoplasty.  I do not like the way they look on their own and I especially do not like what they do for a person's overall look.  I think they need to be fixed, but every situation is different.  Send photos and operative note if you can.  Every situation is different and needs to be evaluated as such.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 22 reviews

Fixing a hanging columella through revision rhinoplasty

+2

The columella (portion of the nose between the nostrils) can appear to be "hanging" for a multitude of reasons. It is important to address this issue with a revision rhinoplasty specialist, in order to diagnose the cause of your issue and address it appropriately. In some cases this can be as straightforward as a slight shave of the underlying medial crura of the lower lateral cartilages. More frequently, I address this issue by straightening the columella with a nice, straight piece of cartilage taken from the septum, what is called a columellar strut. In other cases, the infratip (area below the tip) is overrotated, in which case additional maneuvers or cartilage grafts to recreate a normal tip/infratip relationship may be needed. As others have mentioned, retraction of your nostrils can accentuate the problem. With photos, I would be able to analyze your situation further but hopefully this is helpful.

Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 22 reviews

Hanging columella can be an unsightly deformity

+2

See an experienced rhinoplasty surgeon in your area and have them examine your nose.  If the problem is simply a hanging columella there are many procedures to improve this.  However, an experienced rhinoplasty surgeon my uncover other problems that need to be addressed.

Toronto Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Hanging columella can be improved

+2

Increase in nostril show can be the result of a hanging columella and/or alar retraction and many times a combination of both. The good news is that it can be corrected with revision surgery.

Web reference: http://www.naturalrhinoplasty.com/html/rhinoplasty_aesthetics.php

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 125 reviews

Revision rhinoplasty for nasal tip and hanging columella

+2

In situations like this, it is best to consult with a revision specialist. Bring along your pre and post-op photos and operative reports. Hopefully, your surgeon can help visualize what is bothering you about your current nasal form (and perhaps confirm what you've said). Things are usually a bit more complicated than they seem, and an experienced surgeon can help determine what revision (if any) would be right for you.

Hope this helps.

Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 31 reviews

revision rhinoplasty for hanging columella

+1
 The hanging columella is addressed with a columellar-plasty.   To perform a columellar-plasty, skin and caudal septal cartilage are trimmed back and the new columella is sewn inwards and upwards. It is important not to over rotate the tip. For many examples please see the link below to our columellar-plasty photo gallery

Web reference: http://www.seattlefacial.com/progallery/columellary_photos05.html

Seattle Facial Plastic Surgeon
5.0 out of 5 stars 52 reviews

Should I Go for Revision Rhinoplasty Because of Hanging Columella?

+1

It seems as though this has been on your mind for quite some time.  Since it bothers you, then yes, get it evaluated for a complete diagnosis and if it is an isolated hanging columella it can be addressed in a very straightforward manner.  Best wishes.

Orange County Plastic Surgeon
5.0 out of 5 stars 3 reviews

Revision Rhinoplasty

+1

Most swelling should subside after 12 months, therefore if you are still unhappy with the final outcome I would recommend consulting with your Board Certified Facial Plastic Surgeon to contemplate a Revision Rhinoplasty.

Orlando Facial Plastic Surgeon
4.5 out of 5 stars 14 reviews

Fixing a hanging columella is possible

+1

Shortening your columella can be done with incisions inside the nose. This can be as simple as shortening the septum. The solution really depends on the cause of the hanging columella, which is usually the septum. A rhinoplasty surgeon can examine the area and feel the cause of it. 

-Dr. Zoumalan

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 11 reviews

Hanging Columella in Revision Rhinoplasty

+1

A hanging columella may develop with overly aggressive rotation of the tip of the nose or with overtreatment of the tip cartilages. In terms of revision, this is technically challenging but relatively less invasive than other issues. Dealing with the tip only shortens the recovery time after the procedure. In some cases, revision for this type of issue can be performed without opening the nose. Best of luck moving forward!
 

Web reference: http://www.sanfranciscofacialplasticsurgery.com/revision-rhinoplasty.php

Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 26 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.

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