Do I have a droopy tip and/or hanging columella? Can these be corrected after primary rhinoplasty? (photos)

Question

I had rhinoplasty a year ago and while pleased with the bridge, I still have a hanging columella & droopy tip. In fact, my tip, which was never bulbous, now appears larger & droopier from the front than before. My surgeon used a cartilage graft in the tip for support; however I think it's making the tip look bulkier. Can correcting the columella cause the tip to droop more? Can we correct these issues w/out changing the bridge? Is my simulated pic realistic? Thanks for your time & expert input!

Nima Shemirani, MD · Answer

Dear MsDAG,Narrowing the tip, lifting it and fixing the excess columella show can all be done with revision rhinoplastyThe position of the tip graft would determine exactly what it is (or isn't) doing for youWhen you are ready, please see a revision rhinoplasty specialist who can address all of your concernsBest,Nima Shemirani

Kenneth Hughes, MD · Answer

Columellar tuck with tip elevation through any one of several methods can be accomplished with a revision in closed fashion.Kenneth Hughes, MDLos Angeles, CA

George T. Moynihan, MD · Answer

Thank you for the photos.  From the photos, it appears your nasal tip cartilage has been narrowed by moving them towards the center of the nose which often causes downward movement of the tip of the nose.  This can definitely be corrected by elevating the tip with wither the lateral crural overlay technique or lateral crural transposition.   You consult with a plastic surgeon that has has significant experience with revision rhinoplasty surgery.  Best of LuckGeorge T. Moynihan, MD

William Portuese, MD · Answer

A hanging columella is composed of  both cartilage and skin. This can be addressed with a columellar- plasty. The skin on the left and right sides of the columella is trimmed back along with the cartilage to tuck the columella inwards. The droopy tip can also be lifted up as well, if needed. For many examples of a columellar plasty,  and other revision rhinoplasty procedures, please see the link below.

Tae Ho Kim, MD · Answer

After one year, not much is going to change.  Your hanging columella will not and the nasal tip will remain bulbous.  The nasal tip is probably the most challenging area of rhinoplasty, so I would certainly advise you to see a board certified plastic surgeon with a lot of revision rhinoplasty experience, like myself, to examine you and offer you a surgical plan.  It is not easy to perform rhinoplasty in general.  Revision rhinoplasty can be even more difficult.  Good luck!

Do I have a droopy tip and/or hanging columella? Can these be corrected after primary rhinoplasty? (photos)

Answers (5)

Answer: Hanging columella and droopy tip

Answer: Hanging columella and droopy tip

Answer: Revision rhinoplasty is needed. Your expectation is realistic.

Answer: Revision rhinoplasty is needed. Your expectation is realistic.

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Do I have a droopy tip and/or hanging columella? Can these be corrected after primary rhinoplasty? (photos)

Answers (5)

Answer: Hanging columella and droopy tip

Answer: Hanging columella and droopy tip

Answer: Revision rhinoplasty is needed. Your expectation is realistic.

Answer: Revision rhinoplasty is needed. Your expectation is realistic.

Browse related questions

Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.