Hanging Columella - How Would It Be Fixed? (photo)

Question

Years ago, I had a septoplasty with some work done to the bridge. I'd like to know your recommendations to properly fix the hanging columella. The hanging columella is the most obvious when I'm smiling. I have other "minor" issues with my nose, but I'm not looking for perfection. I hope that I would be able to fix it without having to do anything else. I could post only four photos on this site, so I hope what I posted is helpful.

Michael R. Menachof, MD · Answer

It certainly would be possible to just take care of your hanging columella. Technically, there are several relatively easy ways to do this. Remember, however, that the nose is all about perspective. Once you change one part of the nose, other parts of the nose, that looked okay to you before, may now not look quite right. I would worry, for instance, that once the columella is better, you my feel that the tip looks too big and boxy. You would be a perfect candidate for computer imaging. This way, your surgeon could show you what your nose would look like once the hanging columella was fixed, so that you could make sure that you liked the result. You could then compare this result to an imaged picture of a more complete rhinoplasty in order to help make the best decision. Good Luck.

Todd C. Case, MD · Answer

In addition to  shaving off a little bit of the caudal cartilaginous septum, you can resect a millimeter or two of the membranes septum to try to improve the appearance of the hanging columella.

Francis R. Palmer, III, MD (retired) · Answer

The Columella is hanging but as you say, there are other issues aesthetically with the nose.  The bridge is very low :scooped" and the tip is over-rotated which is one of the reasons the Columella is so obvious.  The crural feet of the tip, in the Columellar area, is separated and has created an obvious groove making the Columella more pronounced.  

	
		 To treat the hanging Columella alone, I have used a Columellar tuck procedure that can be performed without a Rhinoplasty.
	
		If the rest of the nasal tip is to be addressed, this would require a Tip plasty.
	
		If the nasal bridge was to be built up, a dorsal graft would be required as part of a full Rhinoplasty.


	 Hope this helps.

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

There is a bit more than a hanging collumela here. However, to answer your question,  a trimming of the caudal septum and repositioning of the medial crura of the lower lateral cartilages should do it. That said, you also have tip bossae and over-resected upper lateral cartilages, that may be causing some nasal obstrution. You may want to address correcting the lower lateral tip cartilages as well.

Best.

Dr.S.

Hanging Columella - How Would It Be Fixed? (photo)

Answers (4)

Answer: Hanging Columella - How Would It Be Fixed?

Answer: Hanging Columella - How Would It Be Fixed?

Recommended reading

Everything you need to know about Septoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.

Hanging Columella - How Would It Be Fixed? (photo)

Answers (4)

Answer: Hanging Columella - How Would It Be Fixed?

Answer: Hanging Columella - How Would It Be Fixed?

Browse related questions

Recommended reading

Everything you need to know about Septoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.