Is It Possible to Correct a Hanging Columella with a Closed Rhinoplasty?

Hello,

Although the hanging columella may be caused by many different anatomical variations, yours appears to be due to the cartilages that involve your entire nasal tip, known as the 'lower lateral cartilages'.  In your situation, you have an accentuated curvature of the part of the cartilages below the tip but are also affecting the tip as well. 

Proper treatment for your cartilage would involve using internal sutures to rebend the cartilage complex into a more pleasing shape.  Usually, an cartilage graft is utilized as well, called a 'strut' to reinforce the suture work and stabilize the cartilages.   It is true that this can be done with a closed rhinoplasty, but it would still require extensive internal manipulation and incisions to visualize and expose the tip cartilages.  Although many surgeons might argue that they can do it closed, no one would disagree that open rhinoplasty is technically easier and provides the best visualization and access to address the problem.

Best of luck to you!

Hello,

It is possible to elevate the columella with a tongue and groove in a closed procedure.  A nylon suture to the septum will elevate the columella. 

Dr. Nassif

A "hanging columella" is noted when the central portion of the nose (between the nostrils) hangs more than 2-3mm below the nasal rim. This condition can be due to an elongated septum or large nasal spine. In either case, it is relatively easy to fix this without performing an incision across the columella (open rhinoplasty). This procedure could potentially be done under local anesthesia. The surgery would involve partial removal of the anterior septum or nasal spine and partial resection of the mucous membrane.