Is it possible to remove the cartilage from the bottom of the nose as a minor procedure? (Photo)

Question

I know it sounds dumb and it's really a personal concern. But I've been obsessing about how much I hate my nose and how self concious it makes me, for the longest time now. When I'm not smiling, you can see in my nose when you look at my profile. And when I smile, there is a big piece of cartilage that is more visible, making my nose appear larger.

Frank J. Ferraro, MD · Answer

Thank you for the good question. My patients and I discuss all the aspects of the rhinoplasty and what changes they desire. A hanging columella can be very obvious to patients and the changes are relatively simple compared to a full rhinoplasty. The approach would require an open rhinoplasty and an incision to correct it.

Andrew Miller, MD · Answer

Your feelings are not dumb at all. It is perfectly natural to want to look a bit better. As for your nose, while you wouldn't require a large rhinoplasty to correct your issue, it is usually bigger than a "minor procedure" because all of the parts of the nose interact together. So if you simply cut a piece of it off, the tip may droop some. When adjusting the area of the nose that concerns you, sometimes the tip cartilage needs to be fixed, and sometimes it's the septum or both. Be sure to see a rhinoplasty specialist who can examine you and tell you exactly what needs to be done.

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for sharing your concerns with us.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

Richard W. Westreich, MD · Answer

Hi ncpxx,From the photos you show, it appears that you have a fullness in the lower nasal tip, or infratip lobule, region. These cartilages may be too long, causing then to bend out in some patients. It is also possible that your septum is long in that area. Addressing this typically requires a small cartilage graft to help straighten the area. Sutures or other interventions can be done to make the original cartilages straighten and take the form of the small and straight cartilage graft. While this can be done using a mini-open in the office, the cartilage harvest can be difficult under local anesthesia. It is a minor procedure, but some twilight anesthesia would be recommended.

Tanveer Janjua, MD · Answer

It is possible to remove or shave off some of the cartilage and the tip of the nose that can help reduce the appearance as shown in the photographs.  It can be done under local anesthesia in the office without much downtime.RegardsDr. J

Anthony Corrado, DO · Answer

From your pictures and information it seems like you are talking about correcting the excessive columellar show at the bottom of the nose.  Columellar show can be corrected with a small procedure which reduces the caudal nasal septum, and repositions the medial crura appropriately to allow for less columellar show.  A cartilage graft may also be used. I would suggest follow up with a rhinoplasty surgeon to have a thorough examination of your nose.  I have provided a link below.  Good Luck!

Garrett H. Bennett, MD · Answer

If you feel the bulging area between you upper lip and nose you will feel a hard ridge. Your issue is a prominent nasal spine. It is made of bone and you probably would want to be asleep when it was corrected. You actually don't have a hanging columella but your cartilage is separated and you can see it on both sides of your septum. I won't say anything else because I would need you to tell me what bothers you first. Imaging of your photos will help you see what is possible and what you like.

Howard Stupak, MD · Answer

Believe it or not, the answer can be yes.  The middle section of the base of the nose is too long for your facial structure.  This is due to an overly long septum (wall between the nostrils) that pushes the fleshy part or columella down.  Conventionally, this is called a hanging columella and suturing techniques are used to re-support the columella.  However, as the problem is the septum, this and the nose itself must be shortened through an inside the nose incision, thus lengthening the lip and restoring your smile to harmony.  This shortening also has the potential to straighten the entire nose if slightly deviated as well.

William Portuese, MD · Answer

A hanging columella is created from excess skin and cartilage at the base of the nose. A columella plasty can be performed under local anesthesia or under general anesthesia. Most patients are most comfortable with a brief general anesthesia, because  It is very difficult to get that area completely numb, and  the numbing shots are very painful in that area due to many nerve endings.  The excess cartilage and skin is removed. For many examples, please see the video and the link below

Steven Wallach, MD · Answer

It is  difficult to determine what might be best for you without an exam in person or at least better photos. Isolated photos in just two views is not super helpful. Best of luck.

Is it possible to remove the cartilage from the bottom of the nose as a minor procedure? (Photo)

Answers (17)

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