How To Address Hanging Ala and Create Harmony With Columella? (photo)

I have overhanging ala on both sides of my nose, although it's much more prominent on one side (see pics). Part of the reason why one profile looks different than the other is that my nasal bones and septum are actually canted. But that's another issue altogether. What I'm looking for information on right now is how the hanging ala would be addressed. I want to create that nice relationship between the alar margin and columella. Thanks.

Doctor Answers 3

Tip rhinoplasty

It sounds like you think the outer nostril rim near the lip lies to low. Your posted photos do not support that premise. They show notching of the nostril rims (left more than right) where the alar groove meets the nostril rim. That notching can be corrected by swinging the tip cartilages downward and/or placing a cartilage graft just below the tip cartilages to push the notches outward.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 1 review

Alar issues

Each side of the nose is a bit different.  An exam in person would be beneficial to determine what would be best for you.  

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Hanging Ala

The problem is primarily retraction of the nostril rim which can be corrected with small cartilage grafts under the skin at the nostril margin. The alar-facial junction can be repositioned, but I don't think that will be necessary.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 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.