Should I Go for a Hanging Columella Revision? (photo)

I had rhinoplasty/septoplasty 10 months ago. Although my breathing is great now, I am concerned with the appearance of my tip. My columella hangs way to much making my nose appear heavy. My doctor said that he can fix it by shaving columella down. I am worried that there's more to it than just an excessive columellar show. Should I go with what he says or should I seek a second opinion? Thank you. Katarina

Doctor Answers 7

Hanging columella correction during revision rhinoplasty

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Hanging columellas become obvious from a pronounced columella or from alar retraction.  You may need a combination of corrective procedures to help improve a hanging columella. 

Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 reviews

Hanging columella revision

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A hanging columella is a relatively easy surgical fix to perform called a columelloplasty.  This is usually performed under general anesthesia.  A small portion of both cartilage and mucus membrane are trimmed back to tuck columella in so that the alar columellar relationship is more in proportion. Breathing out of the nose will not change, as the procedure simply removes the excessive columellar show.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

How to repair a hanging columella

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Hanging columella repair in your case may require more than just shaving the columella. You have a quite significant columella show. This may be from a combination of an excessively long caudal septum and/or excessively curved medial crura.

If you're not comfortable with your surgeon's explanation I'd suggest getting a second opinion from a different rhinoplasty specialist. You should have someone who is well-versed in hanging columella repair do your revision surgery. They should be able to show you before and after photos of other patients who've had similar surgery so you can see their results.

Check out the link below for more information about treating excessive columellar show.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
4.9 out of 5 stars 22 reviews

Repair of your hanging columella may be more involved than you think.

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I read your concerns and reviewed your photos:

Without an exam, it's difficult to say exactly what's causing your hanging columella. It appears to be from an exaggerated curvature of the medial crurae of your lower lateral cartilages as a result of your prior rhinoplasty. Your septum may be too long as well.

You may require an open approach for correction, so the experience of your surgeon is important. You may wish to consult several reputable revision rhinoplasty surgeons before proceeding.

All the best to you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Columella Revision

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Hello Katarinam in Australia,


First of all, I would suggest that if you don't have confidence with your Doctor's suggestion it would be in your best interest to get a second opinion.  It is important that you have a good connection with your surgeon.  It is possible to have a columella revision surgery to reduce the droop.  

Thank you for the question.


Dr. David Alessi

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

Hanging columella?

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You may have a hanging columella, retracted alar or both.  It is always best o be seen in person for exam.  Speak to your surgeon about options.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Revision for Treatment of a Hanging Columella Post Rhinoplasty

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The hanging columella can be raised with a revision procedure. If you're not comfortable with your surgeon's recommendation, get a second opinion even if you have your primary surgeon do the surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.