My hanging columella seems to be getting worse and I want to know if it can be fixed with a closed approach? (photos)

Question

I had breathing problems when I was 17 years old and had my nose opened up and grafted. I have a scar where it was opened. 15 years on and my nose seems to be drooping more and the inside of my nostrils are exposed which is causing me great distress. I'm so scared about going through it all which is why I wanted a closed approach. I do not care about the rest of my nose, its the exposed columella that bothers me most. Thank you.

Lucian Ion, FRCS · Answer

Dear Emma12146,The problem seems to be related to a combination of curvature of the columella and retraction of the left nostril. The fire from below suggest that the intermediate crura are deviating to the right with the tip domes leaning over to the right. The soft triangles are rather different on the right and left sides. I suspect the columella show from the right is considerably less than from the left. The most likely mechanic is that the procedure was not associated with increased support to the tip and as result the pressure of the soft tissues has bent the soft intermediate crura and bucked slightly the medial crura.You have several options:- Leave it as is - it is likely to be stable but will not get better on its own- Reduce the columella curvature. It would look better from the left but possibly a little worse form the right. - Reduce the columella curvature and lower the left nostril without changing the tip. Less reduction in curvature would be needed but it would not be possible to increase the symmetry of the tip - An open tip tip plasty to improve tip symmetry since this is most likely the foundation for the problems you are experiencing.

Paul Jason Skoll, MBChB, FRCS, FCS(SA)Plast · Answer

Hi,The short answer is "yes". The singular proviso being that the surgeon is experienced and comfortable with using the closed approach - this is most important. Good luck!

Peter Callan, MBBS, FRACS, MBA · Answer

Hi there. You have a combination of columella show and alar retraction, both of which contribute to the problem you describe. I can understand why you want it fixed.The approach depends on the surgeon and reflects their methods. Either approach will work, it is the surgeon that matters the most. Looking at before and after photos will help you decide.I hope this helps.

William Portuese, MD · Answer

Absolutely, that's the best way to reduce the hanging columella is with a closed rhinoplasty. The procedure involves removing of extra skin and cartilage in that area to tuck the columella inwards and reduced the hanging columella

My hanging columella seems to be getting worse and I want to know if it can be fixed with a closed approach? (photos)

Answers (4)

Answer: Can my hanging columella be fixed with a closed rhinoplasty approach?

Answer: Can my hanging columella be fixed with a closed rhinoplasty approach?

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My hanging columella seems to be getting worse and I want to know if it can be fixed with a closed approach? (photos)

Answers (4)

Answer: Can my hanging columella be fixed with a closed rhinoplasty approach?

Answer: Can my hanging columella be fixed with a closed rhinoplasty approach?

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Recommended reading

Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.