Hanging Columella and Overprojective Nose? (photo)

I'm 25 and have a large, overprojective nose with a hanging columella. Is it possible to reduce columella, nostrils, nose projection and wideness from the front on the same time, and do I have to have open rhinoplasty? I'm considering a surgeon who is located in my hometown, but on his website gallery I couldn't find similar nose shapes. Is my nose is a complicated "job"?

Doctor Answers 4

Rhinoplasty for hanging columella

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Your posted photo shows an overly forward projected tip, a tethered upper lip with a horizontal crease and a protruding columella. The columella and lip can be addressed by some combination of muscle removal, lower edge of cartilage septum removal and adjustment of the nasal spine. I do not think addressing only one of these factors would give you a result you would be happy with. The forward projection of the tip can be reduced by reducing the length of the inner legs of the C-shaped tip cartilages. All of this can be done at the same surgery.

Some surgeons can do this and prefer to do this via a closed rhinoplasty. I prefer to do the tip cartilage work via an open rhinoplasty because I feel it gives me better control of and a more reliable end result.

Since you did not include a frontal photo I cannot say much about wideness visible from the front. If you are look for alar base narrowing that can be problematic when performed at the same time as an open rhinoplasty if the surgeon is not careful.

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

Hanging Columella and Overprojected Nose

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Based on your photos it appears that you would be a good candidate for rhinoplasty, such as the example in the link below

Hanging Columella and Over Projected Tip

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All of your goals are reasonable but select an experienced rhinoplasty surgeon because these subtle changes are challenging. You should see results in patients with similar noses; you want to achieve a natural, non-surgical appearance.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

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The simple answer is yes, all those goals can be achieved simultaneously.  Can all those things be done through a closed or endonasal rhinoplasty approach?  Probably not as well as an open rhinoplasty appraoch.  The small incision used for an open rhinoplasty approach would heal extremely well with your skin type, and become nearly imperceptible.  Also, to narrow the width of your nostrils, you will have to have incisions placed at the base of your nostrils (alar base modification/Weir/sill), which would also heal incredibly well if meticulously performed.  Your nose will take "finesse", so in that sense it is more complicated than some, but in the hands of an experienced surgeon you should get a very nice result.  

Donald B. Yoo, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 60 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.