Never seen a nose like mine; is it possible to fix it? (Photos)

Is it possible to make the nostrils smaller with it still looking natural? It's easier to take something away than to add something and it seems like you would need to ADD skin/cartilage and is it possible?

Doctor Answers 10

Hanging columella

Based on your photos, it appears that you have a "hanging columella".  This is usually excessive septal cartilage that pushes the columella, or the cartilage/skin between the nostrils, down. You also may have slight nostril arching, exacerbating the issue on profile.  These issues can be improved with rhinoplasty.  You might consider having someone perform digital "morphing" to show you what might be possible with surgery.

Richmond Facial Plastic Surgeon
5.0 out of 5 stars 24 reviews

Rhinoplasty for smaller nostrils

I have seen plenty of noses like yours :)!  What you are calling too much nostril is called a hanging columella or excessive columellar show.  You also have alar notching because of weakness of the cartilages that make up the tip of the nose.  There are several maneuvers that can help this problem.  Trimming of the caudal septum, removing some of the lining inside the nose, and grafting of cartilage to the weaker portion of the tip, and sometimes even composite grafting.   What would help most is a thorough exam and consultation to discuss your options.

James C. Marotta, MD
Long Island Facial Plastic Surgeon
4.8 out of 5 stars 79 reviews


Thank you for your question and photographs.

It appears that you have a hanging columella and enlarged nostrils. This can often be treated by trimming the caudal septum and making an incision on the inside or outside of the nostrils then removing a specific amount of tissue to reduce the size and/or make more symmetrical. I recommend that you schedule a consultation with a board certified plastic surgeon who specializes in rhinoplasty to have a nasal examination performed and a review of your medical history to see if you are a good candidate for these procedures. Best of luck in your endeavors.

James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 75 reviews

Alar retraction

you do, in fact have nostril show.... this can be caused by a 'hanging columella,' retracted nostrils or a combination of the two.... you columellar/philthral column angle (between your nose and upper lip) is close to ideal for a woman... although your columella could be moved up a bit by a variety of surgical techniques, it will also imperative to lower your alar rims as well

Your tip is a bit boxy in that your tip cartilages have what's called a wide angle of divergence and the footplates flare a bit... refining your tip appears fairly straightforward and would round off your nostrils and make them slightly less elongated without any type of nostril incision

Make sure to visit a few surgeons and get a thorough evaluation and surgical plan....the best chance to get it right is the first time...

Good luck....

Richard Mark Winters, MD
Hackensack Plastic Surgeon
5.0 out of 5 stars 9 reviews

Is It Possible to Fix My Nose?

With the limited pictures you submitted I suggest you have your surgeon lift the columella (the strip between your nostrils) , possibly add cartilage to lower your arched nostril rim, and refine and narrow the tip  which will address the concerns you've described.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Columella issue

You might have a hanging columella which can often be treated by trimming the caudal septum. It may also be flaring of the nostrils that may respond to grafts but the alar will be thicker.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Repair of a hanging columella may be considered during rhinoplasty surgery.

Your columella appears to hang on profile view, and this excessive nostril show may be addressed during rhinoplasty surgery, depending on your examination. Hope this helps you. Dr Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 421 reviews

Normal nostrils

Im not sure what is wrong with your nostrils -- they look normal to me. I would not put grafts in them - it would just make them thicker. Let an experienced rhinoplastic surgeon evaluate you in person. 

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Alar batten grafts

Hello and thank you for your question. Based on your photograph, you may benefit from alar batten grafts to help reduce your alar flare. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 131 reviews


Yes, it's possible to decrease your nostril size. From the two pictures you submitted, I think decreasing the "columellar show" ( the skin in between the nostrils is hanging down) would help you the most. Yes you could elongate the nostril edge but that is much more difficult than pulling up the columella. I think you would have a great result and be very happy with that kind of rhinoplasty.  

Samir Undavia, MD
Princeton Facial Plastic Surgeon
5.0 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.