Is there a way to fix a hanging columella without surgery? (Photo)

Question

I've seen that tips can be lifted with injections and/or threads, is there a chance something of this nature would work for a hanging columella that is more promenent on one side? Can threads be injected into the columella to lift it? Or altenatively is there a way it could perhaps be trimmed without a complete surgery? Many thanks.

Nelson Lee Novick, MD · Answer

Threads carry a significant risk of adverse reactions, including infection, skin dimpling, and spitting out of the threads through the skin surface. Fillers can be be used to treat this problem. First, a robust lHA lifting filler can be injected in a bolus at the base of the columella to elevate it. Next, microboluses of a resilient, cohesive filler can be injected along the base of each nostril in order to lower it to provide greater coverage of the columella. The result: a much less exposed and visible columella. Treatment generally takes about ten minutes tops in experienced hands. Fillers for the nose is not a procedure to be left to novice, medspa type injectors. Make sure to consult with a board certified cosmetic dermatologist. Best of luck.

Donald Groves, MD · Answer

Hello and thank you for your question! Unfortunately, NO non-surgical options can effectively address a hanging columella with associated nasal tip asymmetry (as in your case). The best solution is rhinoplasty, which can refine your nasal structure while preserving your natural features—fillers simply don’t have the structural strength to achieve the necessary changes, and would not be able to pull the columella up. Threads are similarly a poor solution and would distort your anatomy worse.

Your hanging columella is due to the underlying anatomy- specifically the cartilage. To achieve a more balanced facial profile, a rhinoplasty would selectively refine the tip, pulling up and securing the hanging/drooping columella to a more appropriate position while maintaining harmony with the rest of your nose. At the same time, any tip asymmetry would be addressed. This is actually a very common reason patients seek rhinoplasty.

The specialized maneuvers required to address your specific issues need a high level of expertise and experience, which most surgeons simply do not have. In addition to reshaping your nose aesthetically, your septal cartilage (or an alternative graft material) would be used to create structural grafts, reinforcing key areas like the columella (the strip of tissue between your nostrils), and the nasal ala (sides of your nose). This is crucial to maintaining long-term symmetry and preventing future distortions.

Rhinoplasty is one of the most technically demanding procedures in all of plastic surgery—millimeters make all the difference. If a surgeon is only performing one or two rhinoplasties per month, they simply do not have the level of experience necessary to achieve the best possible result. Your nose defines your entire face—this is NOT a surgery to leave in the hands of just anyone.

I have had extensive training in complex rhinoplasty, working under one of the highest-volume rhinoplasty surgeons in the world (who performs 1,000+ nose surgeries per year). If you’re serious about getting the best possible result, I’d be happy to see you for a consultation (Virtual or In-Person) where we can discuss your goals, perform a detailed examination, and create a customized plan for your ideal nose.

I'm actually located right here in Los Angeles. I look forward to helping you achieve the refined, balanced nose you deserve!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Eric M. Joseph, MD · Answer

Generally, a hanging columella involves an excessive curvature and hang of the columella. There is no way to use threads to lift this upward. Typically, rhinoplasty techniques are utilized to straighten a columella that has a curve. Thank you for your question. Sincerely, Dr. Joseph

Philip Michael, MBBCh, FRACS, FRCS(Ed) · Answer

Many thanks for your enquiry. Threads and injections are gaining popularity but have their inherent limitations and associated potential complications. With this in mind, surgery would be preferential and could potentially be undertaken through a closed approach if your concerns were limited to the columella.
Best Wishes

Robert Ciardullo, MD · Answer

Fixing a hanging columella: The only way to lift a hanging columella is surgically. This can be done as an isolated procedure or in conjunction with other parts of a rhinoplasty, depending on what is appropriate.

Is there a way to fix a hanging columella without surgery? (Photo)

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