Can fillers in columella lift the nasal tip a bit or not? Conflicting responses?

Question

Some doctors are saying it can and others say it doesnt? Whats the truth? Can filler lift the tip or not if it is added only to the columella and no where else? I dont want to add filler ontop of my nose or on the bridge or anything. I love my nose on one side and not the other but overall I like the size and all. However from the front it looks a bit droopy and literally only needs to be lifted a tad bit. I am not looking for/expecting a drastic change.

Donald Groves, MD · Answer

Hello and thank you for your question! Unfortunately, no non-surgical options can effectively address a hanging columella or can properly rotate/lift the nasal tip. 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.

Your hanging columella, droopy tip, or under-rotated/under-projected tip is due to the underlying anatomy- specifically the cartilage- which would need to be addressed and adjusted to give the desired changes. This is something only possible with surgery- 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, the projection and rotation of your tip could be precisely adjusted. These are actually very common reasons 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 California. I look forward to helping you achieve the refined, balanced nose you deserve!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Eric M. Joseph, MD · Answer

Temporary gel fillers may be used to give the illusion of tip rotation, however, there is no possible way that a filler can mechanically lift the nasal tip. That is probably where there is confusion. Thank you for your question and I hope this is helpful. Sincerely, Dr Joseph

Jason Emer, MD · Answer

fillers can be placed into the tip and septal angle but columella will not lift the tip.  you need to post photos and see an expert.  see link.  Best, Dr. Emer.

Gerald Minniti, MD, FACS · Answer

Placing filler in the columella will not lift the tip; product needs to be placed directly beneath the cartilaginous tip complex. Filler only works by one mechanism: filling, i.e. adding volume. This will increase tip projection.

William Portuese, MD · Answer

In our practice, we do not recommend  fillers placed in the nasal tip or the columella since it is not FDA approved for that application, is only temporary, and can have significant complications such as skin necrosis.  A closed rhinoplasty can accomplish your goals with all the  incisions placed on the inside of the nose.  No external incisions are required, and no painful packing is required.

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