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!

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.

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.