Am I good candidate for columellaplasty? (Photo)

Question

I don't need a perfect nose. I don't dislike my nose enough that I am willing to take the risk of a full rhinoplasty and the possibility for not liking the changes or having issues. However, my columella hangs more on one side and I dislike that side more (picture 2 and 3). I also don't like my nose while smiling so hoping trimming the columella would help a bit with that as well. Thanks!

Jonathan Kulbersh, MD · Answer

Hello, and thank you for your question. In general, yes, it is possible to only correct a hanging columella without significantly altering other structures. The appearance of hanging columella can be the result of having a long septal cartilage, having retracted nostril rims, or both. If it is solely due to the septal cartilage, removing a few millimeters of cartilage from the bottom through an incision inside the nose can help you achieve better nasal symmetry.

To know the right cause and approach, have a face-to-face evaluation with a reputable board-certified facial plastic surgeon, particularly one with a strong rhinoplasty portfolio. Such experts will have a deep understanding of the aesthetic and functional elements of the nose while having an eye for symmetry and balance. Your surgeon will evaluate your nose and facial profile, recommend the best approach to address your concerns and goals, and help ensure the best possible results.

George Bitar, MD · Answer

You have a nice looking nose.  I agree that you do not need a full rhinoplasty.  I think you would benefit from tip rhinoplasty to even out the columella and improve the tip position when you smile.  This can be accomplished in 1 hour either under local anesthesia or general anesthesia by an experienced, board-certified plastic surgeon who is well-versed in tip rhinoplasties (open or closed).

Zoran Potparic, MD · Answer

Only on the basis of in person evaluation, an experienced board certified plastic surgeon, expert in rhinoplasty, could give you a good answer. Columella reduction is a simple procedure which can be done in local anesthesia with minimal downtime but, one has to be sure that you would benefit from it. In some cases, 3 D simulation may help. Good luck.

Daniel Barrett, MD · Answer

Dear StellaFrank,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

The lower edge of your septal cartilage is probably crooked. If so, it could be corrected simply by trimming the lower septal cartilage. That’s part of many basic rhinoplasties. If that’s the case it’s pretty straightforward but I can’t say if it’s something more complicated

Thomas Trevisani, MD · Answer

in person exam is essential. Based on limited photos- it appears that you would benefit from  Cosmetic rhinoplasty -preferably performed through a closed technique. In order for the nose to look its best -all elements of the nose must be addressed. I suggest that you seek an experienced Board Certified PS

David M. Kowalczyk, MD, MBA, FACS · Answer

Good Morning, Stella! You could perform work on your columella to give it structure. The tongue-in-groove technique works well. The problem with simply trimming the end is that you create a lack of support long-term. Usually suturing and cartilage grafts at the caudal septum provide the most strength to keep the nose where it needs to be and help it resist movement with smiling. This doesn't mean a full-on rhinoplasty is needed but you want it to be done right so it lasts. Hope this helps!

Ercan Demirbag, MD · Answer

Hello , Good Day . From your photos An effective changes can be made in three parts of the nose with tipplasty .

Am I good candidate for columellaplasty? (Photo)

Answers (8)

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