Does Lifting or Retracting the Hanging Columella (Only) Result In a Shorter Nose Tip or Tip Projection? (photo)

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.

 

Lifitng the hanging columella does not have to impact the tip directly.  The tip can be treated in different ways separately from the columella.