When I push on my columella up with a finger, it feels like there is no tissue in the hanging part of the columella.

A hanging columella can be simple to fix but it depends on your cartilage anatomy.  A thorough evaluation is necessary.  Suture suspension of the columella alone can often result in a long term failure of the suspension, and therefore one must consider a restructuring of your nasal cartilages which can be more involved.  These procedures and their variations are very routine for me and I would recommend an in-person consultation.  Have a nice day!

This is a dirty which can be done under local anesthesia and you can go to work the next day. The support suture is put inside the skin and the skin sutures dissolve.

A hanging columella may be readily corrected with incisions made exclusively inside the nose. Usually some of the membrane in the columella is removed and the remaining tissue is sewn up into position. At times, some cartilage must be removed as well. The recovery is about one week. Any residual sutures left inside of the nose can absorb on there own with time.

The precise way to fix your hanging columella depends quite a bit on your specific anatomy. It isn't a one size fits all approach. The technique used would dictate the recovery time, etc.

It is a problem that usually isn't very difficult to address and sutures can be used to secure the medial crura cartilages (that help make up the columella) in a more upward position.

A hanging columella is improved by trimming the membranous columella and cartilaginous columella.  The angle of cartilage removal can turn up the nose or turn down the nose depending upon the desired effect.  If the cartilage is already retracted, then it will be only membranous removal.  This could be done under local anesthesia or general anesthesia.  The sutures are dissolvable and remain intact for approximately 1 week after the surgery.  

To do photo imaging with your own photo, download our iPhone app free of charge.  Just enter "Seattle Plastic Surgery with Dr. Portuese" as search terms.  Once downloaded, you can simulate rhinoplasty by changing the amount of columella show.

The hanging columella is easily addressed after a thorough examination. It is important that I examine each patient since the cause of the hanging columella maybe due to soft tissue or cartilage. During the examination, I can diagram the pertinent antomical issues.  If it is secondary to cartilage, I determine whether it is septal cartilage or the external lower lateral cartilage. Removal of excess tissue and suture techniques will work for  soft tissue issues but cartilage resection maybe required. I recommend performing this in the operating room under intravenous sedation. Healing time is relatively quick with sutures removed in four days and mild swelling lasting about 7 days. No packing would be needed. Good luck with your search.

You can attach the cartilage of the columella to the membrenous septum and that may correct the problem. It is a surgical procedure. My question to you is have you had a nose job done before and if not is there another thing you are concerned about with you nose. I think you need to see a plastic surgeon for a consultation so that a full evaluation of you nose and face can be done and the appropriate procedure performed.

While this may be a very straightforward issue, it may also be only part of a more complex problem requiring more significant reconstruction.  The first place to start is with a specialist in rhinoplasty for an evaluation.  Don't be surprised if the correction is fairly involved. 

A hanging columella  can be fixed very simply by providing  support  either with suturing to the caudal septum or with resction of some of the membranous septum and "tightening".

In your case, since there is adequate redundant soft tissue that you can feel above the columella (the membranous septum) this tissue can be reduced. The cartilage in the columella can be fixed in a higher position either by sutures or by using a strut graft as a support.