Should I Get a Hanging Columella Reduction or Something Else? (photo)

I am 22 year old male. I know my nose is not perfect but I like everything about my nose except the tip. I really do not want an intense or crazy rhinoplasty and would prefer to only work on the tip. I was just curious what would be the best route to take on getting a pointier, less bulbous nose tip. I have researched the suture technique or soft tissue reduction but just want more opinions.

Doctor Answers 6

Tip Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your hanging columella can be lifted and secured with sutures. Your retracted nostril rim can be lowered with small cartilage grafts taken from your septum. Your tip can be narrowed and refined by the removal of a small amount of cartilage and/or sutures to change the contour.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 42 reviews

Nasal tip plasty is possible as stand alone surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Yes, surgery can be limited to tip surgery alone.  It is possible to achieve your stated result without complete rhinoplasty.  However you should leave technique choice to your surgeon 

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

How can I improve my tip?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Looking at your photos, your tip looks slightly rounded and you have so called "excess columellar show" which is partly due to alar notching.  You may also benefit from the narrowing of the nostrils width.  Basically, you need a tip plasty to correct all of the above; this can be done either through open or closed rhinoplasty approach depending on surgeon's preference and expertise.

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

Tip-plasty versus columellar-plasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 A  columellar-plasty involves shaving down caudal septal cartilage and skin just on the inside of the columella. This tucks the columella inwards and prevents the columellar show. A tip-plasty would involve a combination of either cartilage removal or tip suturing techniques depending upon what is required. Both of these Procedures can be performed by closed rhinoplasty techniques as an outpatient procedure. Please see the link below for examples.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 155 reviews

Isolated Tip Rhinoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Based on the limited photos provided, it appears you might benefit from an open tip rhinoplasty procedure. This should be able to provide you with a more defined tip while making your columella appear less heavy/prominent overall. Seek out a rhinoplasty expert in your local area to ensure the highest chance of success. Wishing you the best of luck.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 44 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

When planning a rhinoplasty it is important to discuss with your plastic surgeon what your goals are and what can safely be achieved

David L. Abramson, MD
New York Plastic Surgeon

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.