Can my hanging columella be corrected? (Photos)

I have a lot of nostril show that I would like corrected, however I feel that my nose is already angled upward and cutting back the tip would give me a "pig nose". Is this true or is there a way to correct this?

Doctor Answers 7

Columella nostril relationship

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Thank you for your question and photo.  

From your photo it appears you do have a little bit of an over rotated tip - it does appear slightly higher than ideal.  You could potentially control the rotation with some tip adjustment and the columella can be reduced slightly by shaping the cartilage from below.  I would be cautious about balancing these two movements - as you have correctly stated, it's important to not make it appear over rotated and "pig" like.  This may also look exacerbated if you have some work done to reduce the dorsum profile.

You will likely need some cartilage grafting and tip work to appropriately shape the nostrils, tip and columella to a balanced, aesthetic relationship.

Hope that helps,

Christopher C. Chang, MD

Washington DC, Maryland, and Virginia

Washington DC Plastic Surgeon
5.0 out of 5 stars 20 reviews

Rhinoplasty procedure for hanging columella and retracted alar rim

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From the one limited photograph, it appears that there is a combination of  alar retraction and a hanging columella. The hanging columella can be reduced by trimming back excess skin and cartilage from both sides of the columella on the inside of the nose. To fix alar retraction requires a composite skin graft taken from the ear and placed on the inside of the nose to bring down alar rim to be more proportional to the columella. Both procedures are probably required. For more information and many before and after examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Rhinoplasty, some advices:

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Thank you very much for sharing your concerns with us.

The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.

In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.
With this procedure you get a delicate nose, better harmonize with your other facial features.

Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 366 reviews


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Hello and thank you for your question. Based on your photograph, you may benefit from alar batten grafts to improve your alar retraction and produce less nostril show.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 172 reviews

Can My Hanging Columella be Corrected?

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You have a hanging columella, retracted nostril margins, and a short nose which can be corrected with cartilage grafts. Your hump can be removed at the same time. Be careful to select an experienced rhinoplasty specialist to make these changes and achieve a natural non-surgical appearance.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Hanging columella

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Excess columellar show has a number of causes. The view that is shown reveals a disproportionate relationship between the nostril and the columella. The nostrils may be a little high and there might be excessive septal cartilage at the junction of the lip. Securing good tip support along with elevation of the posterior aspect of the columella will help to maintain a good relationship after the surgery. During your consultation with your doctor other photographic views will be helpful as well as physical examination. 

Jennifer Parker Porter, MD, FACS
Bethesda Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Rhinoplasty for columella

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thank you for your question and photo. You are right that your nose is upturned a little more than desired. Also the ala are slightly retracted. A rhinoplasty can help make small adjustments to all these aspects to obtain better rotation And ala-columella relationship. More information can be obtained after a consult and exam

Jeffrey Jumaily, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

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.