I would love my hanging columella to be reduced and to have a shorter nose. Is it possible? (Photos)

Based on your photos, you are a good candidate to have your columella revised. Often times, a little tip revision is needed at the same time to make everything blend well. Be sure to see a rhinoplasty expert for consultation.

Thank you for sharing your question and photos. Based on what you’ve described, you appear to be a good candidate for a revision rhinoplasty to address the columella. Your nasal tip projection and rotation look good, which is an excellent starting point. I recommend consulting with a board-certified facial plastic surgeon who has extensive experience in revision rhinoplasty and utilizes 3D photo simulation technology. This can help you visualize potential outcomes and set realistic expectations.

A hanging columella is actually one of the easier things to correct in rhinoplasty. It’s not a difficult procedure. In most cases, I can fix it through a small incision on the inside of the nose meaning there are no external scars.

What we typically do is remove a small amount of the cartilage that’s pushing the columella downward, then place a few precise stitches to secure it in a better position. The procedure usually takes about 20 to 30 minutes, and recovery is generally quick.

It’s a great question and yes, it’s absolutely possible to improve the look of a hanging columella safely and effectively.

Hello and thank you for your question. Based on your photographs, you are a great candidate for a revision rhinoplasty. Maneuvers for your surgery would include dorsal hump reduction, tip refinement, nasal tip deprojection, tip elevation, correction of hanging columella, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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

This is a totally reasonable request to get done if you really want it fixed. You may be able to only do it all via closed, depending on what was done.

Based on your photos, I agree that you have a hanging columella. Since you have had previous rhinoplasty surgery, much of this is due to a bit of retraction of your nostril margins. Additionally, there is an exaggerated angle between your columella and infratip lobule. Revision rhinoplasty techniques maybe utilized to repair a hanging columella, microdroplet Silikon-1000 injections maybe considered for lowering your nostril margins, and for lowering your tip on profile several millimeters. I hope this helps! Sincerely, Dr Joseph

The hanging columella can take away the beauty of the whole nose. It can be corrected with a quick procedure done under local anesthesia. The skin behind is excised in an elliptical fashion to pull the columella backwards when the edges are sutured together. The sutures are dissolvable and if you are out of state you don't need a follow up. I have plenty of videos on this procedure on YouTube.
Regards
Dr. Janjua

It's very common for a surgeon to lower a bump on the bridge and ignore what that does to the length of the nose. For a number of reasons, the surgeon must play close attention to the length when lowering a bump, or else the nose will look too long after. Although you posted photos that cropped your nose out (!!), it seems that raising the drooping columella won't do the trick. The entire tip, including where the "tip" part sits (the part that you would touch with your fingertip to show where the tip of your nose is) -- that part needs to be elevated as well. Great surgeon-produced morphs would probably show that to you.

Remember that rhinoplasty, and especially revision rhinoplasty, is an exquisitely difficult operation to get right, and you should only have surgery if you are able to make yourself very confident in your surgeon's skills. The changes that your nose needs require advanced techniques, and skill that most plastic surgeons don't possess with expertise. It's much better to not have surgery than to have inexpertly-performed surgery.

Hanging columella is only seen in elderly people and not in all of them, I mean about real droopiness of the columella due to its flaccidity and the failure of the ligaments joining it to the caudal septum, this is a condition for aging noses and never found in other scenarios. What you have is an excessive columellar show due to abnormal structures in terms of positioning and shape. In the end the effect is visually alike to a really hanging aging columella, however there are huge differences.

This may sound as a technical quibble or scarce relevance, but it is not, the treatment of your condition has nothing to do with the aging columella that hangs low, in your case a full re-structuring is needed so that the root causes of the columellar show are properly addressed; which are these causes? Read on:
-a severe case of verticalized lateral cruras (aka "parenthesis tip deformity"), which prompt the ascension of the alar rim (alar rim retraction) and this leads to the visibility of the columella and septal mucosa; additionally this creates a boxy tip and poor nasal valve function (I bet your breathing intake is prone to collapse if you apply great effort in it); the higher the alar rims are positioned the more columella is visible
-abnormal location of the tip, it is too high but not exactly upturned but because the medial cruras (located beneath the columellar skin) are too long and curvy, like arcs, hence shaping the tip domes overly high and bowing outwards-downwards hence aggravating the columellar show

There are other issues in your nose like the dorsal hourglass shape, deserving attention too.

The treatment in your case SHOULD NOT be pushing up the columella, that'd lead to a terrible piggy nose deformity, the solution is complex but routinary in the hands of structure rhinoplasty surgeons:
-the columellar vertical cruras have to be reshaped or replaced by a more straight structure, and shorter
-the tip domes, the tip itself, has to be rebuild / relocated at a lower position, according to the new medial cruras
-comprehensive lateral cruras repositioning and caudal extension grafting of the lateral cruras, so that the alar rims are pushed down to a balanced location

That's how your columellar show is treat, not best treated, it is the only (acceptable) treatment.

yes, a hanging columella is a common thing to be addressed during rhinoplasty surgery- whether during a primary operation or revision. This generally entails re-positioning the lower cartilages of the nose and supporting them in their new position- often with cartilage graft such as a septal extension graft or columellar strut graft. Find a well-qualified plastic surgeon with advanced training in rhinoplasty surgery to review your concerns and come up with a surgical plan that is tailored to your goals.
Sean M Fisher MD Aesthetic Plastic Surgeon Seattle, WA