What would you recommend to fix my hanging columella?

Question

Hello. My columella is hanging and nostrils are very big. I would like to fix it. When i touch my columella, its soft. I can push it in the right place but when i do it, my upper lip lifts too. So my question is, if i get columella lift, my upper lip lift too?

Brock Ridenour, MD · Answer

A hanging columella can be caused by one or more common anatomic variations including an over-developed nasal septum, weak or bowed mesial crura, redundancy of the membranous septum, long or plunging lateral crura, and true nostril retraction. Happily, it is possible to surgically correct a hanging columella without changing the position of the upper lip. Wide or excessive nostrils can also be narrowed during the same procedure. Best of luck.

Rod J. Rohrich, MD · Answer

There
are multiple different ways to correct a hanging
columella. This will depend on the cause, which will range from a long caudal septum
to a wide or displaced medial crura. This should be done as part of an  open rhinoplasty
in the hands of a Board Certified Plastic Surgeon or ENT with significant Expertise
in Rhinoplasty.

Jonathan Kulbersh, MD · Answer

The columella is composed of cartilage, tissue and skin.  It can "hang" or droop from a variety of reasons:1)  The septal cartilage is large pushing the columella down2)  The cartilage in the columella is weak, floppy, wide or overly curvedYou can tell the cause by pushing on the columella.  If it stops on the hard septum then the septum is pushing the columella downward.  If you can push up the columella in the correct location, then the cartilage in the columella need to be corrected.  There are many ways to correct a hanging columella.  If the septum is too large, then it will need to be made smaller.  Wide columellar cartilages would need to be trimmed.  One of my perferred method to improve a hanging columella during a rhinoplasty is a tongue and groove technique where the cartilage of the columella is anchored to the septum to pull up the columella.Correcting the columella should not effect the upper lip.I hope this helps.

Steven Wallach, MD · Answer

Without seeing photos, it is difficult to say what could be done for your columella.  Best to be seen in person.

William Portuese, MD · Answer

Fixing a hanging columella is treated by removal of skin and cartilage from the base of the nose.  Two incisions are made on the inside of the nose along the columella and the  excess skin and cartilage is removed. This is usually performed under a brief general anesthetic for patient safety and comfort. For many examples, please see  the link and the video below

What would you recommend to fix my hanging columella?

Answers (7)