Columella and nostrils - how would a surgeon address this issue? (Photo)

Hi, It is better for you to consult with your facial plastic surgeon who can examine you and give you opinion based on examination.

Based on your photos, you appear to have had previous rhinoplasty surgery, and in your after photos, you appear to have nostril retraction. Depending on your examination, you may be able to achieve nostril lowering on both sides for a more pleasing nostril contour appearance. I hope this helps! Sincerely, Dr Joseph

Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. Alar contour grafts could be placed to help improve the alar notching. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Thank you for your query. You will need an augmentation and lift of the dorsum and the tip of your nosed. The latter can help with improving the shape of the columella as well. The medial limbs of your cartilage when brought together and lifted will make the columella look more aesthetic. Please find an experienced board certified Plastic surgeon who can examine you and help you with all your concerns. All the best!

When patients have a hanging columella, a columella-plasty is performed which involves removal of an excess amount of skin and cartilage in that area from an incision on the inside of the nose. When patients have wide nostrils, an Alar plasty is performed.