Fixing hanging columella make nose appear wider/expose nostrils? (Photo)

Question

I am happy with all of my nose accept the tip that hangs down super low. Worse when smiling. I am interested to know avg pricing for the work that would have to be done. Also my concern is if they "bring up" the hanging columella that my nose will look wider or I'll have too much of my nostrils exposed giving me that turned up pig nose. Can my hanging columella be fixed while preventing the other two things from happening?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your
photograph, this can be fixed.  It is likely to caudal portion of your septum which is causing this.  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

Thomas Trevisani, MD · Answer

It appears that your concerns are valid. To achieve your goals you would need a Rhinoplasty to address the entire composition of the nose. When we alter one aspect of the nose - all of the other relationships are changed. So, yes- your goals are achievable - in the right hands- by a very experienced Board Certified Plastic Surgeon. Costs will vary according to many many factors, see the link attached:

Adam Bryce Weinfeld, MD · Answer

You don't have a hanging columella as much as you have alar retraction anteriorly which is revealing a lot of your columella.  It is also what makes your tip look long, as if it is drooping down, when you smile ( the infratip lobule is out of proportion).  I solution is the address the lower lateral cartilage lateral crus structure and use alar rim grafts - I would not reduce the caudal septum, that will make your nose look too turned up (over rotated).

Barry L. Eppley, MD, DMD · Answer

From the front view it does appear that your nose tip hangs down too low. But from the side view that does not appear to be the case at all. I think that if you just do some nasal tip reshaping with alar rim grafts you should not make the nose look wider or develop more nostril show.

William Portuese, MD · Answer

A tip rhinoplasty is required to fix the isolated hanging columella.  The hanging columella can be addressed with excision of excess skin and cartilage from varying  areas on the columella to the tip upwards or downwards by  altering the angle of removal. Releasing the depressor set the ligament will prevent the tip from drooping when smiling. For more information and many before-and-after examples of reducing the hanging columella, please see the video and the link below

Fixing hanging columella make nose appear wider/expose nostrils? (Photo)

Answers (7)