One year post rhinoplasty - do I have a hanging columella? Should this be fixed? (Photo)

Question

Hi, i hada rhinoplasty 1 year ago and have noticed my nose columella is dropping. Is this irregular and would I need surgery to fix this?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photograph, you are a great candidate for rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, correction of alar retraction, correction of hanging columella , 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

Jeffrey H. Spiegel, MD · Answer

Limited view in your photo. Your nose looks basically fine but if you don't like the amount of columellar show, it can be addressed quickly and easily in the office.

Yasemin Aydinli, MD · Answer

Thank you for your question and photo. A 'hanging columella' refers to the columella &mdash; the strip of skin and cartilage between your nostrils &mdash; sitting lower than the rim of the nostrils, so that too much of it shows in profile. It can be present because of the natural shape of the lower cartilages or the caudal septum, and occasionally it becomes a bit more noticeable after rhinoplasty as swelling fully resolves. At one year, most of your swelling has settled, so what you're seeing now is likely close to your final result, which makes this a reasonable time to evaluate it.
Whether it needs correction really comes down to how much it bothers you and how much columellar show is actually present on exam &mdash; a small amount is normal and not everyone needs treatment. When it is corrected, it's usually a relatively focused revision: trimming or reshaping the caudal septum and/or refining the medial crura of the lower cartilages to bring the columella into better balance with the nostril rims. It's generally a more minor adjustment than a full rhinoplasty.
I'd suggest an in-person assessment so the exact cause and degree can be determined and you can decide whether correction is worthwhile for you. If you do pursue revision, choose a surgeon experienced in revision rhinoplasty.

One year post rhinoplasty - do I have a hanging columella? Should this be fixed? (Photo)

Answers (3)

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