Hanging columella and square nose tip (Photo)

Hi, I am wondering if I would be able to correct my nose without going under general? Also, how would you repair the tip of my nose as it seems very square with prominent sides and a hollow centre and my septum seems crooked. I absolutely hate it when I smile as it becomes so much mkre prominent. Thanks!

Doctor Answers 3


Hi.  Your nose is pretty good to start with but there are subtle improvements that could be made. I would advise septoplasty with a tip rhinoplasty and shaving 2 mm off the dorsum.  This would subtly improve the profile and refine the tip.  I agree the tip needs to be elevated and the columella revised.

Whilst it is possible to have the tip rhinoplasty alone done under twilight anaesthesia I would highly recommend a GA and certainly if you want all of the above refinements then you need a proper anaesthetic.




Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. You may also benefit from a cephalic rotation of your tip to turn up your tip slightly and a conservative dorsal hump reduction.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 reviews

Nose issues

Your nose looks fine and in nice proportions to your face. If you want to alter it then you would need a very subtle change which in some ways is more difficult - you have very thin skin and this makes these changes even more challenging so you would certainly need a specialist rhinoplasty surgeon and would need a general anaesthetic 

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