Can I fix my hanging columella and bulbous tip? (Photo)

Hi @rae2123. I recommend seeing an expert rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. A rhinoplasty in my opinion is one of the most difficult procedures to perform. In my practice, I utilize piezosurgery. Piezosurgery is a more gentle technique that allows for greater precision. Less bruising and swelling is common with Piezosurgery. In a typical rhinoplasty, a hammer and chisel technique is performed leading to more inadvertent fractures. Best of Luck, Dr. Nima!

Thank you for your question.

I would Best recommend the latest Ultrasonic Rhinoplasty device Piezo®:

In traditional Rhinoplasty, surgical instruments known as rasps and osteotomies (hammer and chisel) are used to reshape the nasal bones by removing the hump and/or narrowing the nasal bone width. These tools are relatively imprecise and their use can lead to contour irregularities, etc. if not used in the proper manner. Recently, a technology that uses sound waves has been developed to contour nasal bones in a precise and far less traumatic way when compared to traditional techniques. Ultrasonic, or Piezo, Rhinoplasty is now the most advanced technology available for minimally traumatic nasal bone reshaping and hump removal during Rhinoplasty. There will be hardly any bruising and swelling which will make the recovery period a lot easier for the patient.

Dear rae2123,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would benefit from a rhinoplasty. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for your question. You are an excellent candidate for rhinoplasty. I think it is one of the most beautifying surgeries that we do as plastic surgeons. In your case, the issues, in particular, the hanging columella can easily be resolved. It is important to only see plastic surgeons with extensive experience in rhinoplasty, ie perform at least 6 per month and have performed hundreds of cases. Also, critically evaluate their on-line galleries to see if their art form resonates with yours. Rhinoplasty is definitely a grey haired plastic surgeon's sport. Best wishes to you.

Thank you for taking the time to share your question and photos.
The best option for you is to find a surgeon that is board certified in both facial plastic surgery and otolaryngology in order to properly address your hump and hanging columella aesthetic and possibly functional needs. The enhancement you are looking for can potentially be addressed with a closed scarless rhinoplasty. In the hands of a properly experienced surgeon, this technique is beneficial because of the avoidance of a scar on the outside of the nose, much more rapid and comfortable recovery compared to an ‘open’ rhinoplasty, and less disruption of the nasal tissues. Additionally, if you have nasal breathing issues, you may be able to use your health insurance to offset a significant portion of the cost.

Good luck!
Behrad Brad Aynehchi, MD

Your hanging columella and bulbous tip can definitely be addressed with a rhinoplasty. I recommend you see an experienced rhinoplasty surgeon for a consultation. This will take a fair bit of nasal tip work ams whether or not the bridge of the bake will also need to be addressed at the same time cannot be determined with the photos provided and without a personal consultation. In general, if you alter one parameter and area of the nose it affects adjacent areas. It would likely be best to also have work on the bridge done to create a balanced nose.

Best wishes,
Thomas Walker, MD, FACS

Thank you for your questions and for sharing your photographs.

Yes, you can have a rhinoplasty purly to address your concerns at the tip of the nose (Tip Plasty).
This will avoid any significant bruising as the nasal bone at the top of the nose is left intact. I do appreciate that you do not care about the bridge being crooked. However, you may change your mind after Tip Plasty surgery. Therefore it is best to consult with an experienced rhinoplasty surgeon and ideally review morphed images which would give you better understanding of what to expect and also to ensure that you and your surgeon are on the same wavelength.

Best wishes,

A full rhinoplasty would be required to make the required changes to your nose such as reduction of the hanging columella, and adjusting the nasal tip cartilages. Due to the crooked bridge line and dorsal hump, a full rhinoplasty is going to be required. An Thorough internal examination the nose is going to be required to see if you have a deviated septum present blocking your airflow. A septoplasty can be billed patient's medical insurance it once medical necessity has been documented. Expect to pay for the entire cosmetic rhinoplasty yourself.