Does lifting or retracting the hanging columella (only) result in a shorter nose tip or nose projection?
Does Lifting or Retracting the Hanging Columella (Only) Result In a Shorter Nose Tip or Tip Projection? (photo)
Doctor Answers 9
A hanging columella can be corrected either alone or in combination with shortening the nose. To shorten the nose as well. More of the columellar cartilage would be removed at. The tip and also redundant mucosa also removed. In either event the procedure is less involved and works better using the closed rhinoplasty technique, in my opinion. The procedure takes about one half hour and the recovery quite easy with no bruising , that is unless you have other things done to the nose at the same time.
Treatment of Hanging Columella
A hanging columella can be corrected with or without changing nasal length or tip projection. An experienced surgeon will explain your alternatives so you both can achieve the desired result.
Correcting the hanging columella and its effect on the nasal tip.
Excessive columellar show can have 2 underlying causes: 1) An overly long columella (comprised of both the caudal septum straddled by the medial crus of both lower lateral cartilages) and 2) Alar margin retraction (nostril rims). One or the other or both of these factors can be contributing to the problem. There are different ways to correct excessive columellar show and each will have its own unique impact on tip and nasal base aesthetics as described below.
Correction of excessive columellar show, therefore, can be performed in one of 2 ways: 1) Resecting a segment of the caudal edge of the septum and raising the medial footplates of the lower lateral cartilages superiorly. Depending on the shape of the cartilage resection from the caudal margin of the septum, the impact on the columella-lip relationship and nasal tip aesthetics will vary. If the resection is performed with the majority of cartilage removal near the base of the columella (posterior columellar angle) then the effect will be to decrease the columella-lip angle giving the illusion of more downward tip rotation even though there will be essentially no change in the tip position. If the septum resection is such that more is removed near the tip (anterior septal angle) then the effect will be to increase the columella-lip angle and result in a modest upward rotation of the tip. This will also decrease the length of the nose slightly but have no impact on tip projection. If the resection is equal at both the anterior and posterior septal angles then there will be very little or no impact on the columella-labial angle and tip rotation. 2) The second way to reduce excessive columellar show is to place cartilage grafts along the nostril rims (alar rim grafts). This will have no effect on the nasal tip.
Although the pictures you provided are not ideal, it would appear that in your case the main problem is that the columella is overly long and to a lesser degree there is mild nostril retraction. It would be best for you to discuss correcting this with one or more of the options above and use simulation imaging to see what suits your desires best.
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Lifitng the hanging columella does not have to impact the tip directly. The tip can be treated in different ways separately from the columella.
A hanging columella can also impact the tip
We can't tell from your photo the exact issues, though the hanging columella can be lifted without impacting the tip, and the columella can be adjusted in such a way as to reduce tip projection, increase rotation, or shorten the nose. Computer imaging can sort out just what looks 'right' to you.
Does Lifting or Retracting the Hanging Columella (Only) Result In a Shorter Nose Tip or Tip Projection?
Performing a Columellar tuck for a hanging Columella gives the illusion of rotating the nasal tip downward (making the nose appear longer) not to be confused with tip projection which decribes how far off of the face the tip extends...the tip itself does not cahnge rotation.
Hanging columella surgery can be done several ways.
Hanging columella surgery can be done several ways. You can lift the columella and only do that. You could increase or decrease the tip projection as well as shorten the nose.
Reducing collumelar show
Reduction of the collumella should not have any impact on your tip projection if it is performed correctly. I may be that you have collumelar show because of an elongated caudaul septum or over -projected medial crus of the lower lateral cartilage. See link below.
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.