Hanging columella, retracted alar rim, or both? (Photos)

Question

Hi, I am looking to address the tip of my nose. I am unsure if I have a hanging columella, retracted alar rim, or both. My concern is mainly being able to see into my nostrils from the side profile which tends to be more obvious when I smile. Thanks

Jonathan Kulbersh, MD · Answer

Thank you for your question and photos. You appear to have a hanging columella, which can be addressed during a rhinoplasty procedure. Excess tissue can also be removed to make your nostrils appear more narrow and symmetrical.

Since rhinoplasty is one of the most complex of all plastic surgery procedures, experience, skill, and even artistry are required to ensure the best outcome. I recommend scheduling an in-person consultation with an experienced, board-certified facial plastic surgeon, with expertise in rhinoplasty techniques. They will be able to assess your concerns and determine the best course of action to help you achieve your aesthetic goals.

Nima Shemirani, MD · Answer

Hi @Mellllanie. Thank you for sharing your photos. I recommend seeing an expert rhinoplasty specialist for an in person examination. There are options for you that can be determined after examination.

Best of luck,

Dr. Nima

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.I have evaluated your case from the photos you provided and I can say that you have a retracted columella and you need an alar base reduction. Believe me with a rhinoplasty surgery you can have a more elegant and feminine nose. Your nostrils show too much when you smile probably because of the retracted columella, your tip can tend to be droopy.Best regards!

Andrew Miller, MD · Answer

It appears as though you have a bit of both. During rhinoplasty, the columella can be brought up some and supported better so that it doesn't droop when you smile. It's difficult to bring the nostrils down when it's your natural anatomy. Be sure to find a rhinoplasty specialist for consultation.

Eric M. Joseph, MD · Answer

Based on your photos, there is an exaggerated curvature of your Columella that is causing it to hang. Sometimes this is associated with a long nasal septum. If this is something that's causing you significant dissatisfaction, please consider Consulting with several reputable rhinoplasty specialists who offer computer Imaging so you can see what might be best for you moving forward. Hope this helps! Dr Joseph

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi
It is a hanging columella. This along with tip refinement can be achieved with a tip rhinoplasty. I dont think your nose tip depresses when you smile, rather the lip elevates. If it is only this that bothers you then you could consider anti wrinkle injections. 
Cheers
Damien

Zoran Potparic, MD · Answer

You have very subtle columella deformity which can be fully evaluated only on in person basis. Consultation with a board certified plastic surgeon about collumela, nostrils, nose tip, should be your next step. Good luck.

Ronald J. Edelson, MD · Answer

You definitely have a hanging columella. It is easily corrected by shortening the septal cartilage that is dragging it down.  Alar retraction is typically something seen after rhinoplasty and is more difficult to correct

Robert Ciardullo, MD · Answer

Hanging columella or retracted alar rims? The main defect is the hanging columella. You do have a slightly high arch to your Alar rims but I would say that 75% or more of the issue is with the hanging columella. at any rate I would only address the Columella if you were to proceed with surgery and leave the alar  rims alone.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

Your nasal appearance on the side her lateral view is excellent you have very good tip projection and a nice straight dorsum.

I would show what I see simply columellar show and I would not call your columella a hanging columella and I do not see Alar retraction.

If you are terribly bothered by this a tip rhinoplasty can be done and a small amount shaved off your caudal nasal septum to allow the columella to retract inward.  However if this columellar retraction is to extreme you will be unhappy with the appearance.

Hanging columella, retracted alar rim, or both? (Photos)

Answers (10)

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