Hanging Columella on Just One Nostril, What Can Cause This?

Photos would really be necessary to provide you with the best advice. The appearance of asymmetry can be due to the following:

1) Receding nostril on one side
2) Asymmetric tip cartilage
3) Septal deviation

An exam would be necessary to tell for sure, and this would be the next step. There are likely treatment options available, but a revision procedure would be necessary to improve the issue. Your nostril can be lowered if necessary using cartilage grafts if that is the cause. A residual deviated septum can be repaired, and your tip cartilages can be improved as well. Seek the advice of a board certified facial plastic surgeon with great credentials and fellowship training. I hope this helps, and I wish you the best of luck.

You may have a deviated septum under the hanging side of the columella causing the asymmetry.

Another possibility is that your have nostril margin retraction on one side allow more nostril to be seen.

It's hard to saw what is going on in your case with out seeing your nose.

Check out my web reference below to read more about hanging columella repair.

The skin of the columella takes on the contour of the cartilage underneath it.  Your bump can be due to either the alar cartilages or the bottom end of the nasal septum.  A detailed exam would help decide this and the correct cousre of action to correct it.

Asymmetry of the columella is most likely due to asymmetry in the cartilages running down from your nasal tip to the lip. it could also be due to a deviation of the end (caudal) septum. You really need an examination before anyone can tell you more.

A hanging columella on just one side can result from asymmetric positioning of the medial crura (the portions of the tip cartilages which sit between the nostrils). This can occur naturally or following a prior rhinoplasty, if one cartilage settles in at a different height than the other. Pictures and certainly an in-person examination would be useful to assess your situation. 

Correction of this issue can be as straightforward as shaving the lower hanging cartilage, which can be performed through a tiny incision under local anesthesia in the office. However, if there are additional tip concerns, a rhinoplasty focusing on the tip (tip-plasty) may be appropriate. This can be either an open or closed (endonasal) rhinoplasty, depending on the type and severity of issues and the surgeon's preference. I'd recommend seeing a rhinoplasty specialist in your area and ask to see before/afters similar to yours. 

Best regards,

Dr. Mehta

   There can be some footplate or medial crural asymmetry that can cause distortion, but pictures would be helpful here.  Kenneth Hughes, MD Los Angeles, CA

Columella and nostril shapes are conditioned by race, familiar tendency, and can be hereditary. The deviation may be caused by early stage traumas, altering the otherwise natural appearance of tissue growth. It would be good to see a photo to be able to determine the probably problem.

The asymmetric columella can occur for a variety of reasons which include-  post-op undesirable result due to less than ideal surgical technique, associated with a septum on its bottom that is deviated towards that side of the nose where the columella is lower, and sometimes it just is a genetic feature or something associated with some trauma.  This can be corrected with proper surgical steps.

 A hanging columella commonly is on both sides, but with a deviated septum it may favor one side more than the other.

 A hanging columella can occur  on one or both sides. A hanging columella on one side is usually related to a deviated caudal septum which can cause nasal obstruction. This can be addressed at the time of Closed rhinoplasty. Please see the link  and the video below for reduction of the hanging columella in other patients that we have repaired with a closed rhinoplasty approach.