Is there any non invasive way to hide a columella? (Photo)

Question

I have a hanging columella that bothers me because it is so obvious. Is there anything I can do without surgery?

Randal Haworth, MD, FACS · Answer

A hanging columella occurs when the piece of tissue between the nostrils (the columella) hangs down too far and is more prominent than desired. While surgery is the most effective way to correct a hanging columella, there are some non-surgical options that may help improve the appearance of the nose:

Dermal fillers: Injectable dermal fillers can be used to add volume to the surrounding tissue and help balance out the appearance of the nose. This can be particularly effective for filling in the area under the columella and making it appear less prominent.
Botox: In some cases, Botox injections may be used to weaken the muscles that pull down on the columella, which can help elevate it slightly and improve its appearance.
Nasal strips: Adhesive nasal strips can be placed on the outside of the nose to help lift the columella and improve nasal airflow. While this won't necessarily correct the appearance of the columella, it may help make breathing easier and reduce any discomfort associated with a hanging columella.
It's important to keep in mind that non-surgical options may provide some improvement, but they are generally not as effective as surgical correction for a hanging columella. It's best to consult with a qualified medical professional, such as a plastic surgeon or facial plastic surgeon, to discuss your options and determine the best course of action for your specific situation.

I hope this helps,
best of luck !

Donald Groves, MD · Answer

Hello and thank you for your question! Unfortunately, no non-surgical options can effectively address a hanging columella with increased nostril show (as in your case). The best solution is rhinoplasty, which can refine your nasal structure while preserving your natural features—fillers simply don’t have the structural strength to achieve the necessary changes.

Your hanging columella is due to the underlying anatomy- specifically the cartilage. To achieve a more balanced facial profile, a rhinoplasty would selectively refine the tip, pulling up and securing the hanging/drooping columella to a more appropriate position while maintaining harmony with the rest of your nose. At the same time, the ala would also be adjusted to show less of your nostrils from the side view. This is actually a very common reason patients seek rhinoplasty.

The specialized maneuvers required to address your specific issues need a high level of expertise and experience, which most surgeons simply do not have. In addition to reshaping your nose aesthetically, your septal cartilage (or an alternative graft material) would be used to create structural grafts, reinforcing key areas like the columella (the strip of tissue between your nostrils), and the nasal ala (sides of your nose). This is crucial to maintaining long-term symmetry and preventing future distortions.

Rhinoplasty is one of the most technically demanding procedures in all of plastic surgery—millimeters make all the difference. If a surgeon is only performing one or two rhinoplasties per month, they simply do not have the level of experience necessary to achieve the best possible result. Your nose defines your entire face—this is NOT a surgery to leave in the hands of just anyone.

I have had extensive training in complex rhinoplasty, working under one of the highest-volume rhinoplasty surgeons in the world (who performs 1,000+ nose surgeries per year). If you’re serious about getting the best possible result, I’d be happy to see you for a consultation (Virtual or In-Person) where we can discuss your goals, perform a detailed examination, and create a customized plan for your ideal nose.

I look forward to helping you achieve the refined, balanced nose you deserve!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Eric M. Joseph, MD · Answer

Based on your photos, you appear to be a better candidate for rhinoplasty surgery to correct the hanging  columella Which may be multifactorial.  If you're dead against surgery ,microdroplet Silikon 1000 may be considered for achieving nostril lowering, and reduced nostril show. Hope this helps! Dr Joseph

Nelson Lee Novick, MD · Answer

An appropriately low viscosity, cohesive, malleable HA filler can be used at the base of the nose to provide some lift, as well as in the wings of the nose to provide appropriate camouflage--both of which can help to to diminish the appearance of the exposed columella. A couple of tiny droplets of Botox placed at the base of the nose can additionally support and prolong the lift from the filler placed there. In experienced hands, all of the foregoing typically should take no more than about ten minutes to perform and the results of the filler are typically immediate and those from those the Botox seen in a few days. You would be wise to consult with a board certified cosmetic dermatologist. Best of luck.

William Portuese, MD · Answer

you have a hanging columella which is excess skin and cartilage in that area. A surgical rhinoplasty is going to be required to remove that excess skin and cartilage. The procedure is called a columella – plasty and can be performed under local or general anesthesia

Is there any non invasive way to hide a columella? (Photo)

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