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

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?

Doctor Answers 7

Rhinoplasty candidate

Dear 4warrior4, You do not have a hanging columella what you are seeing is the effect of the lateral crus pushing the medial crus down. This can be corrected by reducing the cephalic portion of the lateral crus and dividing the nasal domes which will give a slight rotation however will not over shorten the nose or looking "pig nose" as you say. I believe reducing the caudal septum would create to much space between the nose and the upper lip and would not be aesthetically pleasing. You may want to consider a small chin implant with sub-mental liposuction to further define your jawline and balance your profile. During consultation imaging would be very helpful so that you can see how these proposed changes will make your nose look and that you and your surgeon are on the same page. An example of the imaging process with final result is shown in the video above. Best regards, Michael V. Elam, M.D.

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Nose Tip

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.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Tip rhinoplasty to fix a hanging columella

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

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Hanging columella

You pose an interesting situation. From the front view it does appear that you could have a hanging columella. From the profile view it appears the problem is in the area of the anterior nasal spine, which is the bony part of the columella close to the lip. If this is taken care of, it should not create a "pig nose" appearance. The tip hanging down too much and getting worse when you smile is a different problem. Something as simple as breaking up the muscles which control the tip may be enough. Of course I am saying this based on 3 pictures that are 2-dimensional and you would need to see a board certified plastic surgeon or facial plastic surgeon with extensive experience in rhinoplasty in person for an opinion.

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon
4.8 out of 5 stars 29 reviews

Hanging columella

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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Fixing hanging columella make nose appear wider/expose nostrils?

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:

Thomas Trevisani, Sr., MD
Orlando Plastic Surgeon
4.9 out of 5 stars 63 reviews

Hanging columella

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).

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 57 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.