Columella reduction - will this fix the slight hanging? (Photos)

Question

Hello. I do not want any other work done to my nose besides the slight hanging. I had a consultation and we agreed columella reduction was appropriate for my wants. But I am second guessing myself. From the front my nose looks super long until i poke at mu columella to see what it would look like it wasnt drooping there. I avoid taking pictures from eye level because of droop. Its not the entire tip drooping.

Donald Groves, MD · Answer

Hello and thank you for your question and pictures. You actually have a very difficult problem to correct- a slightly long appearing nose with a hanging columella and excess nostril show. Unfortunately, a minimal procedure or surgery "just to the tip" or "just to the columella" will not be able to fix your issues- any surgeon that tells you otherwise is either inexperienced or is intentionally doing you a huge disservice. A rhinoplasty can best address your aesthetic concerns and any functional issues with your nose. I would be able to adjust the size, shape, and especially the definition of your nose (particularly the tip and columella), improving your overall facial balance. I'd also be able to open up and solidly reinforce the underlying structural framework of your nose (to prevent distortion and retraction from scarring forces over time)! This would truly be the best option for you.

Rhinoplasty truly is a surgery of millimeters- and whether you're looking for a minor adjustment (as in your case) or a major transformation, it requires exceptional surgical skill to achieve functional and natural-looking results! Because your nose is the DEFINING feature of your face- I would only recommend seeing a surgeon who specializes in rhinoplasty procedures, and who has significant training and experience performing these surgeries. I actually trained under one of the world leading rhinoplasty experts (who performs 1,000+ nosejobs annually).

If you are unhappy with the appearance of your nose, I recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with rhinoplasties) to thoroughly discuss your surgical goals, undergo a formal examination, evaluate your options, and develop a personalized plan just for you. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Selcuk Inanli, MD · Answer

Hello! Thank you for the question.
As far as I can understand from your question Rhinoplasty is a comprehensive procedure and should be approached as a whole. All your desires can be fulfilled in a single surgery; make sure to discuss all your wishes with your surgeon.
It would be better face to face consultation.
Best Regards!

Andrew Miller, MD · Answer

The thing is, with rhinoplasty, it is hard to just simply shave the columella down some because the tip is a three pronged structure, and changing one area usually involves changing other areas. Having said that, with a well performed rhinoplasty, you should be able to give the appearance of primarily lifting the columella while not changing the rest of the tip much - but it needs to maintain support. So go on a couple more consults with rhinoplasty experts that can do computer imaging at the same time.

Eric M. Joseph, MD · Answer

Based on your photos, you may indeed be a good candidate for rhinoplasty surgery to achieve a narrower nasal appearance, with profile deprojection, tip lift, repair if you're hanging columella, and removal of your small dorsal hump. If you have severe dissatisfaction with your nose, please consider meeting with several reputable rhinoplasty specialists who have a large gallery of favorable before and after photos, and many favorable consumer reviews. I hope this helps. Sincerely, Dr Joseph

Gary M. Horndeski, MD · Answer

Your nasal lip angle is 90 degrees and should be 110 degrees.  You would benefit from pulling the tip of the nose up higher.  This will also reposition the columella.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

You have slightly hanging columella but I’m not sure shortening it would make much difference. But the  procedure  is simple and you might get enough change to make you happy. I would definitely perform this as a closed rhinoplasty

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, among other maneuvers. Make sure you are going to a surgeon with hundreds of long-term before and after pictures on their website with standardized lighting and standardized backgrounds. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Tanveer Janjua, MD · Answer

Yes, it can be but in your case it has to be conservative as you columella hangs a small amount.

Columellar Reduction
Columellar reduction to reduce the nostril show is a great procedure. It can be very effective in pulling back the columella and reducing the hang. Procedure can be done under local anesthesia and the recovery time is a day or two. No nasal cast or taping is needed. A small ellipse of tissue (membranous septum or posterior edge of medial crurae / distal septal cartilage) are removed. The fresh edges are sutured and immediately you can see the change. It is important to differentiate a columellar hang from an alar retraction which can also give more nostril show. The treatment for alar retraction is different and can be more challenging. 
Regards
Dr. J

Columella reduction - will this fix the slight hanging? (Photos)

Answers (8)

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