Columella/upper Lip Issues? (Photo)

From your posted photos I am not so sure that you have a hanging columella because on front view the bottom of the columella is not too far below the level of back edge of the nostrils and on side view the bottom of the columella does not stick out far below the mid-nostril axis. I suspect the problem is mostly retraction of the outer rim of the nostrils. That can be corrected by repositioning the tip cartilages and in some cases by placing composite cartilage skin grafts between the nostril rim and the bottom edge of the tip cartilages.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Your photos show excess nasal spine and elongated septum. Your tip is inverted (and full) with nostril flare. Typical correction includes resection of nasal spine to reduce pull on upper lip, trimming of excess septal length, grafting the alar rims to reduce flaring, supporting the tip with grafting, and a conservative tip plasty-- to avoid creating more nostril flare! An experienced surgeon should be able to help you. Best, Dr. G.

You are correct in that you have a hanging columella. Typically, in an unoperated nose such as yours this is usually the result of an excessive nasal spine or excessive caudal or distal septal length. Since I do not have a base view of your nose, I cannot tell you exactly the likely cause. It is also causing you to have an obtuse nasocolumellar angle which makes your upper lip (white part) look too long and the tip itself hangs. This can be corrected during a rhinoplasty procedure and also you may need a septoplasty at the same time depending upon what I mentioned above especially if there are any concomitant breathing issues. I agree with you seeking a facial plastic surgeon for these issues. Good luck.