Could I have my columella shortened without changing tip angle? Thoughts? Open/closed? (Photo)

Question

I honestly have no idea how a rhinoplasty is performed. (Obviously because I didn't go to medical school.) All I know is that when I place my finger right beneath my columella and push upward, that's how I'd like my nose to look. I do not want the angle changed at all otherwise I'd look like a pig. How can this be achieved? Open/closed - in my case what do you recommend? Expected cost? Can it be done under local? Any additional info would be great. Looking for surgeons in California, thank you.

Kenneth Hughes, MD · Answer

You can have a columellar surgery that does not increase the angle of the tip.   I perform these surgeries with closed technique
 to preserve the structure of the nose and minimize visible scarring.Kenneth Hughes, MDLos Angeles, CA

Kristina Tansavatdi, MD · Answer

You have identified what is called a "hanging columella" and the surgery to correct this depends on what is causing the columella to "hang". The causes may be the cartilages of the base of the nose (medial crura) are hanging lower than the other cartilages or the septum is overly long, or the arch of the nostril soft tissue is retracting upwards. A full examination would be needed to give you an adequate answer as to the approach. In general, most of these can be corrected by simple maneuvers through a closed rhinoplasty approach which can be done under local anesthesia and minor sedation. Your nasal tip is beautiful and I would not recommend an open approach which would disrupt the nasal tip. Costs can range from $3000 to $8000 depending on location of the surgery, credentials, and experience.

Could I have my columella shortened without changing tip angle? Thoughts? Open/closed? (Photo)

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