Split nose at the bottom and also low-hanging columella. Can these be fixed without the result looking too fake? (Photos)

Question

I don't want a small nose I just want it to be less ugly. I have a bifid lower nose and very low hanging columela and crooked septum. If the split end gets sutured, will the columela be too narrow when looked facing forward? I just want a normal nose without those ugly features, is this possible without making the nose too small?

Raymond Goh, MBBS (Hons), FRACS (Plast) · Answer

Hi. Thank you for posting your questions and photos.
It is clear that you have separation of your alar cartilage, in particular the middle and medial crura of your alar cartilages. You also have a degree of nostril show, which could be a combination of hanging columella and alar retraction. 
The principle of treating your current problem will involve approximating the separated cartilages, either by suturing them to a cartilage graft, or to the septum, or a combination of techniques. Get assessed by a surgeon experienced in rhinoplasty to discuss your best form of treatment.
All the very best.
Dr Ray Goh

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi. All of your concerns can be addressed quite adequately with a tip rhinoplasty which can give a veey natural result. Cheers damien

Brian M. Harmych, MD, FACS · Answer

Thanks for sharing! Rhinoplasty could address all of your aesthetic concerns. The deviated (crooked) septum should also be repaired if you have nasal breathing problems. Be sure to consult with a board-certified rhinoplasty surgeon that performs many aesthetic and functional rhinoplasty operations. To increase the chance of obtaining a natural-looking result, make sure your get a chance to view a collection of your surgeon's before and after photographs. To ensure you find the most qualified rhinoplasty surgeon, seek surgeons board-certified in either Otolaryngology (ENT), Facial Plastic and Reconstructive Surgery, or a general Plastic Surgeon with extensive rhinoplasty experience.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Your photographs show a separation of your lower lateral cartilage.  This can be fixed with rhinoplasty surgery.  Your hanging columella can also be addressed.  Make sure you specifically look at before and after
pictures of real patients who have had this surgery performed by your surgeon
and not just a computer animation system. 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

Split nose at the bottom and also low-hanging columella. Can these be fixed without the result looking too fake? (Photos)

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