My Columella Shows, What is the Best Way to Treat It?

does my columella show becouse of hanging columella or alar retracment?,what is the best way to treat it?,i would prefer alar retracment,becouse i am pleased with shape of my nose ,i had no previous plastic surgery on my nose.

Doctor Answers 7

How to fix my columellar show?

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You do appear to have true columellar show where the columella is greater that 5mm's on profile view.  There does not appear to be any alar retraction which is typically caused by Rhinoplasty and over-resection of tip cartilages.  A Columellar tuck would be the most appropriate way to reduce the columellar show, IMHO.  I do this through and isolated incision behind the colunella and in front of the anterior septal angle.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Hanging columella

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This does appear to be primarily due to excess caudal septum and could be manged by trimmin that area. If the medial crura did not retract up then you might need some "tongue in groove" fixation as well to set the alar columella ratio.  See how it looks on your whole face with computer imaging before to get a sense of the change.

Michael L. Schwartz, MD
West Palm Beach Facial Plastic Surgeon
4.8 out of 5 stars 12 reviews

Minimize columellar show

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Hi! It does look like your columellar show exceeds the normal 3-4 mm we like to see in an aesthetically pleasing nose. This is a straightforward procedure that can be done with incisions inside the nose, provided you are happy with the rest of your nasal appearance, and nothing else needs to be altered. However, it will give the appearance of a slight shortening of your nose and slight lengthening of your upper lip. Your rhinoplasty surgeon should be able to morph photos to give you an idea pre-operatively of what to expect.

Good luck!

Catherine Winslow, MD
Indianapolis Facial Plastic Surgeon
4.6 out of 5 stars 44 reviews

Hanging tip/columella after rhinoplasty

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It is due to excess caudal septum. I would perform a caudal septal resection among other things, and then assess the nostrils. An alar contouring graft or lateral crural strut grafts may help reposition the ala. However, rhinoplasty is like chess and one move affects the next. This will have to be discussed with your rhinoplasty surgeon and he will determine during surgery what to do. There are a lot of dynamic changes that occur during surgery.

Make sure your choose a rhinoplasty specialist. The best shot at getting your nose right is the first one!

Ashkan Ghavami, MD
Beverly Hills Plastic Surgeon
4.1 out of 5 stars 105 reviews

Rhinoplasty for a hanging columella.

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Just have the "hanging" part of the cartilage  removed and that is all you need! This can be done under local anesthesia and you can go to work the next day.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Best Treatment for Columellar Show

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Hi Peter,

It appears that you have a prominent columella due to your caudal nasal septal cartilage.  Trimming of the cartilage should correct your columellar show.  I do not believe that you have alar retraction.  You should only have it "fixed" if it really bothers you.  Choose your rhinoplasty surgeon most carefully. Good luck and be well.

Dr. P


Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Reducing columellar show with rhinoplasty

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Dear Peter,

From the lateral views of your nose (the side profile), it appears that there is excessive columellar show mostly due to a hanging columella. There are two main components that can contribute to this:

-an excessively long or over developed septum (the firm midline cartilage)

-overdeveloped medial crura (the soft cartilages that define the shape of the columella

Both of these can be treated with a rhinoplasty focused on refining the columella. If you are pleased with the appearance of the rest of your nose, then this makes it even more straightforward, and I think it would be very reasonable to achieve the appearance you desire.

The base view of your nose (the one looking from below) shows some asymmetry of the medial crura (the cartilages that shape the columella) and this can be addressed at the same time.

I hope that helps.

Best wishes,

-Dr. Asaria

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 139 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.