Can I fix my hanging columella under local anesthesia? (photos)

Question

Hello. I like the slope of my nose, I would just like to fix my hanging columella. Is it possible to do this under local anesthesia? And possibly making my nostrils more even.

Michelle Zweifler, MD · Answer

In appropriate candidates, a hanging columella and nostril reduction could be performed under local anesthesia.  There is still recovery and down time even when procedures are done under local.

Mark G. Albert, MD, FACS · Answer

Hello,
Thank you for your question. Most rhinoplasty procedures can't be done under local, but something like this may be possible. You would have to be seen in person for an exam to come up with a definitive plan. This can be done using the closed / scarless approach. I wish you all the best.
Mark G. Albert, M.D., F.A.C.S.New York, NY and Boston, MA

Aytekin Uzer, MD · Answer

Hi. From the photos, your nasal columella is hanging looking. But your nasal tip is too uprised. And your alar rims (upper parts of the nostrils) are on the up position. So there is need a coorection of alar rim position + columellar position and nasal tip postion. And also alar wings look like wide. There may be need for the alarplasty.

Tanveer Janjua, MD · Answer

Yes it can be done under local anesthesia. However nostril symmetry is almost impossible to achieve.
Regards 
Dr.J

William Portuese, MD · Answer

While it is possible to undergo a columella-plasty under local anesthesia come it will be rather painful to get the area completely numbed up under local anesthesia so  that you do not feel the surgery itself.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  A large portion of my practice is dedicated to rhinoplasty.  In your case, I would remove the caudal septum which would help your hanging columella, however you would also benefit from alar contour grafting which would make your nostrils last arched and your nostrils would appear smaller.  You do have a bulbous tip and would benefit from making that more narrow.  In summary, I do not think that there would be enough benefit just from doing the caudal septum excision under local.  You really do need a complete tip rhinoplasty to get the best result.  Best wishes to you.

Larry Weinstein, MD · Answer

Yes a columella lift can be done under local anesthesia. Nostril symmetry can also be tweaked with local anesthesia. Your nose as shown looks very acceptable. Vector computerized imaging may help us visualize probable results. See a board certified ASAPS plastic surgeon in consultation. Good luck.

Ronald J. Edelson, MD · Answer

You do indeed have a hanging columella which could be corrected under local anesthesia. A hanging columella often remains following rhinoplasty but you don't say whether you had previous surgery or not. Either way it's a simple fix. Simply remove a strip of cartilage that's holding your columella down

Steven J. Pearlman, MD, FACS · Answer

Yes a hanging columella can be corrected under local anesthesia in some circumstances. However,, what you have is excess columella show. This also can be a result of a high nostril wall, a long septum or the shape and size of the bottom of the tip cartilage called the medial crura. A personal exam with computer imaging will help determine which is the main cause and best treatment. That will also determine the type of anesthesia that is best.

Marc Polacco, MD · Answer

Thank you for your question. This comes down to your comfort level as well as that of your surgeon. But yes, small adjustments could be made to the columella and nostrils under local anesthesia fairly easily. All the best!

Can I fix my hanging columella under local anesthesia? (photos)

Answers (12)

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