When I push on my columella up with a finger, it feels like there is no tissue in the hanging part of the columella.
Doctor Answers 15
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!
How a rhinoplasty fixes a hanging columella.
The "Hanging Columella" Can Be Fixed
You are correct in asking if the hanging columella can be fixed with suturing after removing some of the "skin" of the columella.
There are other approaches to fixing a prominent columella. The best solution derives from analysis of contributing factors, so the result will look balanced and attractive.
During your consultation with a plastic surgeon, he/she will be able to evaluate what would be the best solution for you.
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How hanging columella is improved
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.
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Surgery for hanging columella.
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.
A hanging columella can be from a long nasal septum or very prominent cartilages (the so called mesial crurare). Both conditions can usually be fixed. The septum can be shortened, and the mesial crurae can be repositioned or shorted vertically. Recovery would be about 1 week. The area will be a bit sore and swollen.
If there is adequate septum above the columella, elevaton and fixation with a suture is a relatively simple procedure which can be done under local anesthesia with minimal recovery. If a graft is necessary to replace missing cartilage recovery will take 7-10 days.
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".
Solution for hanging columella
A hanging colummela is typically corrected by removing some of the mucosa and septal cartilage from the area just behind the columella. The procedure is quite simple and can be done in 10 minutes using dissolvable sutures. The swelling should be minimal because there's very little nasal tissue dissected during this procedure unlike a full Rhinoplasty.