Is it hard/complicated to fix/treat a hanging columella and alar retraction? Would open or closed rhinoplasty be best? (Photo)

Question

Dear Doctors, As you can see in the pictures, I suffer from a hanging columella and alar retraction. Is this something that is usually quite hard to fix? It seems like most doctors don't have that much experience in it. What are the risks? Would it require open or closed rhinoplasty? I know I also have a high nose bridge/a hump but this seems much easier to fix since it's more common. Thank you!

John Layke, DO, FACS · Answer

These are all common issues that are addressed by a rhinoplasty surgeon.  I believe that you are a good candidate for rhinoplasty, where subtle changes in the tip and bridge of the nose will add up to an overall more refined appearance.  I recommend consulting a Board-Certified plastic surgeon who will accurately examine your nose, create a simulation based on what your nose could look like after surgery, and formulate a plan tailored to your individual needs and wishes.  Good luck!

Sirius K. Yoo, MD · Answer

Thank you for your question and photos.  You are correct that alar retraction is less commonly treated than hump removal, but there are many well trained rhinoplasty specialists who are comfortable correcting this type of issue.  Alar retraction can be treated as an isolated procedure or in combination with formal rhinoplasty (which is what I would recommend for you).  There are several techniques to bring down a retracted ala, depending on the degree of retraction and the patient's specific anatomy.  I would probably recommend composite grafts from the back of the ear to the inside of the nose to unroll and bring down your ala on each side in additional to other nasal shape concerns.  See a rhinoplasty specialist in your area who can give you a detailed examination and collaboratively make a plan to give you the nose you are hoping for.  All the best!

William Portuese, MD · Answer

To repair a hanging columella requires 2 incisions placed on the inside of the nostrils, and the excess skin and cartilage is removed. To repair a alar retraction,  a combination of either alar rim grafts, or a composite skin/cartilage graft is performed on the inside of the nostrils. Both procedures can be performed easily with a closed rhinoplasty approach. For many examplesof reducing columellar show and more information, please see link below

Laxmeesh Mike Nayak, MD · Answer

All of your concerns are commonly addressed in rhinoplasty. I tend to prefer the open approach, but would not fault a surgeon who gets good results endonasally.  Visit with a surgeon who can image heir vision for you, and who has the skills to back that drawing up with surgical results.

Dennis Barek, MD (retired) · Answer

I for one never do an open technique. I find them "surgical" looking.That said, some surgeons get reasonably satisfactory results with open technique, if that's what they were trained to do.

Is it hard/complicated to fix/treat a hanging columella and alar retraction? Would open or closed rhinoplasty be best? (Photo)

Answers (6)

Answer: Components of rhinoplasty

Answer: Components of rhinoplasty

Answer: Open or closed tecnique

Answer: Open or closed tecnique

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Everything you need to know about Rhinoplasty

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Is it hard/complicated to fix/treat a hanging columella and alar retraction? Would open or closed rhinoplasty be best? (Photo)

Answers (6)

Answer: Components of rhinoplasty

Answer: Components of rhinoplasty

Answer: Open or closed tecnique

Answer: Open or closed tecnique

Browse related questions

Recommended reading

Everything you need to know about Rhinoplasty

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