Can a hanging columella be fixed with a rhinoplasty? (photo)

The amount of columellar show can be reduced by removing a small degree of skin between the columella and nasal septum. This area of skin (membranous septum) can be removed under local anesthesia. It will not be pain free, but it probably will not be as painful as your first surgery.

Thanks for your questions and photos. Best of Luck!

As with many issues related to rhinoplasty, this is a difficult question to answer. Issues with the columella can be due to a variety of causes. As mentioned in one of the other answers, it could be as simple as removing a little bit of skin and/or mucous membrane just inside the nose, which could be done using a local anaesthetic in the office. On the other hand, it has been my experience that in many of these kind of situations, the real issue is that the tip cartilages need to be rotated upwards (pulling the columella with it). Anything less will often not give a satisfactory result. While it is much easier to do this via an open rhinoplasty technique, it can be done closed in certain situations. In either case, since it just involves the tip of the nose, it can usually be done using a local anaesthetic in the office. Bottom line- the worst possible outcome would be to have a small second operation (chosen because it was small and not because it would likely give the desired result) and still be unhappy with the results. My suggestion- get a couple of opinions, determine the best way to get the result you want, and do that, no matter which approach is needed. Good luck.