Hanging columella on nose needs pushed back in. After 4 previous rhinoplasties, is this going to be simple?

I do not want the nose re broke again. Is there a way to push it in ?

Doctor Answers 5

Columellar-plasty for hanging columella

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A columellar plasty can be performed to reduce the hanging columella. This is accomplished by trimming back  extra skin and cartilage on the inside of the columella on both sides. This procedure can be performed as a stand-alone procedure, or in combination with a rhinoplasty. The columellar-plasty can also be performed  under local or general anesthesia depending upon patient's desires.  For  examples and more information, please see the link and video below

Hanging columella

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It's hard to say for sure from just this one photo but as the previous reviewer suggested your problem may be a retracted ala (nostril rim) more then a hanging columella. either way there are a variety of techniques that can reliably correct either of these problems. Osteotomy is not necessary to address this area of the nose. Good luck!

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Hanging columella....

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I agree with Dr. Laufer.

1.  You need more views: a frontal and a lateral view would be useful

2.  I think you need the following....

a) I like the start off of your columella against the tip.  I do not like the amount of curvature it takes towards the intranasal septum.  I think a large portion of of the distal caudal septum has probably been resected.  I would probably put in a columellar strut.

b) I do not like the retraction of your alar rims.  This is where I agree with Dr. Laufer.  You need some cartilage grafting along the lateral crura of the lower lateral cartilages.


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Hanging columella

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If all you are aiming for in a revision surgery is refinement to the columella and alar rim relationship, there should be no reason to break the bones. You would need a physical examination to determine how much movement is possible in the alar rim, and how much the columella would need to be brought up. Both of these things can be accomplished without significant down time or the need for a large surgery.

Best of luck

David Reinstadler, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Hanging columella after 4 previous rhinoplasties

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Since you provided us with only one left anterior oblique picture it is hard to make a full assessment, nonetheless it appears to me , from this single photo , that your problem is more of a retracted ala,  probably due to over resected lower alar cartilage. This condition will require rim cartilage grafting.

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.