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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!)
Asked 35 months ago by
pinklady in London
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Revison Rhinoplasty To Correct Hanging Columella, Retracted ALa and Bulbosity of nasal Tip
Hi Pinklady,
Fixing hanging Camella is fairly straightforward. A skilled surgeon can correct this problem very easily through incisions inside the nose. You could have it done under local anesthesia. Choose your surgeon carefully.
You want to make sure that you don't have a retraction Ala as these two conditions can be sometimes mistaken or they can co-exist.
With regards to the problem of nasal tip bulbosity that you had mentioned, it can be corrected through revision...
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Fixing a hanging columella through revision rhinoplasty
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,...
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Hanging columella can be an unsightly deformity
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.
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A hanging collumela can easily be fixed.
Of all the secondary deformities after rhinoplasty, a hanging collumela is one of the easiest to correct. And a s a general rule the easier something is, the more successful the result becomes. Plus if nothing else is needed, the degree of revision surgery is reduced so your recovery is faster and easier too. So good luck, I'm optimistic you will be happy after wards.
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Revision rhinoplasty for nasal tip and hanging columella
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.
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Correction of the hanging columella by revision rhinoplasty
I'm going take the liberty to make a few assumptions regarding your hanging columella since there are no enclosed photos. After your primary surgery the hanging columella and nostril retraction developed over the first year. The origins of these problems are complex and located in the details of your operation and your preop photos. Generally the hanging columella can be caused by over rotation of the tip without compensating with caudal septum. It is common to have...
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Correction of a Hanging Columella
A photo would be extremely helpful to determine what your actual issue is in regards to your nose. A hanging columella can be due to retraction of the nostrils/alar rim or a "hanging" of the columella due to a prominent nasal spine or other cartilage issues. Either way the problem is reversible but a proper evaluation and understanding of the underlying cause is essential in order to produce a proper result from revision surgery. A bulbous tip is a secondary issue that needs to be...
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Unhappy with tip , seek consultation
There are several issues you bring up; question of hanging columella, bulbous tip, etc. Even with photos it would be difficult to determine exactly what your needs are and your impresssions are without actually visiting with a physician. In the US free consultations are pretty common, just be sure you are dealing with a Boeard Certified Plastic Surgeon.
I hope this information has been useful to you.
Jon I Sattler, MD, Board Certified Plastic Surgeon, Glendora,...
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Correction of the Hanging Columella
The hanging columella is a complex topic without specifically analyzing one’s nose. It can be due to many different things such as previous nasal surgery, a prominent nasal septum, or can actually be a true hanging columella with retraction of the alar rim. It can be multi-factorial and can be quite difficult to correct. Obviously if it’s a secondary deformity it requires significant analysis as well as operative correction with either cartilage grafts to either lower the alar...
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Hanging columella: a good reason for revisional surgery
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.
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Revision Rhinoplasty for a Hanging Columella?
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Hanging columella - see an experienced revision rhinoplasty surgeon.
You are right. A picture is worth a thousand words. Email me some pics if possible...dr.athre [at] athresurgical.com.
There are several reason that you could have a hanging columella. A revision rhinoplasty can correct this. However it is important to determine why you have a hanging columella first. This is why you should see a surgeon that specializes in revision rhinoplasty.
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Hanging Columella Correction
One of the most common errors of omission from rhinoplasty surgeons are inability to address the hanging columella. There are a variety of solutions to correct this based on what needs to be changed in your nose. Seek a consultation with an experienced rhinoplasty revision surgeon.
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Revision surgery can correct a hanging columella
Revision rhinoplasty surgery can correct the issues you're concerned about. You do want to make sure that there is no alar retraction contributing to the problem. This can also be repair but is a bit more involved.
A bulbous nasal tip can typically be improved upon as well. The methods to address this problem vary depending on your specific situation.
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Correcting a Hanging Columella
If your problem indeed is mostly related to a hanging columella, this can be corrected in a relatively straight forward fashion by an experienced revision rhinoplasty specialist. This usually involves making incisions on both sides of the columella and repositioning the underlying cartilage to achieve the desired shape. It typically takes 15-30 minutes under a local anesthesia to accomplish this.
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Hanging Columella
The 'Hanging' Columella can usually be adjusted easily. Sometimes the position of the ala can be contributing to the problem and in some cases the ala themselves may need to be adjusted. As for the columella - a trim of skin or septum or even lower lateral cartilage may be beneficial. It really shouldn't be a large procedure. Good Luck
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Hanging columella
Generally a hanging columella is a simple problem to correct and can be done in 15 minutes under local anesthesia. If the problem is more complicated such as bowed medial crura causing the columella hang then more aggressive columella work may be necessary; but still could be done under local anesthesia in 30-45 minutes.
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Revision Rhinoplasty consideration for Hanging Columella
Revision rhinoplasty is sometimes considered after the original rhinoplasty surgery to further improve the nasal appearance. Deciding on revision rhinoplasty is usually a difficult decision for both patient and surgeon. Some revision procedures are much easier than other rhinoplasty surgeries. If you're not satisfied with the columella, then a revision may be considered to push it back or similar procedure. Revision procedures are generally not performed right away, but after sufficient...
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Revision rhinoplasty for a hanging columella
After a patient has had a rhinoplasty, a small number of patients may choose to correct a small area of their nose that they feel was not adequately treated with the initial surgery. If having too much flesh in your columella or too low of a columella is a concern to you, this can readily be fixed with a revision rhinoplasty. Keep in mind that revision rhinoplasties can be more challenging than the first surgery so your best bet is to only work with a board-certified plastic surgeon who has...
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Find a revision rhinoplasty surgeon to consult with regarding your concerns
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Hanging Columella
If you're not satisfied wit the columella and tip,I would encourage you to consider a revision. The columella can be raised. While the hanging columella may contribute to to the "bulbous" appearance, you may need additional work to achieve better tip definition. Some seasoned advice would be in order.