How should I correct my drooping tip / hanging columella (male)? (Photo)

The tip of my nose dips, especially when I smile, and I would like to correct this. Please see the attached photos. In some of the photos, I've used my finger to show how I'd ideally like my nose to be shaped. Questions: 1. What would be the most effective procedure to correct this issue? 2. Are there any doctors who specialize in this procedure - preferably in NY but I'm willing to travel? 3. Obviously it varies between physicians, but what's a reasonable price range estimate? Thank you!
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Doctor Answers 8

Rhinoplasty

You need to be seen and evaluated. Tips can be rotated up and a lot can be done to give you the change you want. Best is to see an experienced rhinoplastic surgeon and talk to him about the changes you want. I do this kind of surgery all of the time. Fees vary depending on how much has to be done. At your complimentary consultation you will be quoted what it would cost.


New York Plastic Surgeon
4.1 out of 5 stars 11 reviews

Rhinoplasty candidate for down turned tip and columellar show

 Yes, the rhinoplasty procedure can lift the down-turned tip and reduce the columellar show. A hanging columella is addressed by trimming back excess caudal septum and excess skin in the columella. The tip can also be lifted with a tip rhinoplasty. For many examples of both maneuvers performed during the rhinoplasty procedure, please see the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

How should I correct my drooping tip / hanging columella (male)?

Thank you for your question.

How the Rhinoplasty operation is performed?

There are different kinds of rhinoplasty operations however we can divide them as the one that requires bone excision and the one that does not need bone excision. The main fact that we classify the rhinoplasty operations like that is that the results and postoperative period is associated closely with this fact. In the operations like “nasal tip correction”, “simple rhinoplasty” there is no need for a bone excision however these minor operations cannot be beneficial for everyone. The operation type is need to be determined by the surgeon according to needs of the patient. In these minor operations the rhinoplasty is performed with closed method. The bone and the cartilage tissues are not involved in the surgery directly. Small nasal bumps can be removed in these operations.

In the operation that needs the bone and cartilage tissues to be involved; open approach is used. In the procedures with open approach, the size, shape and functionality of the nose can be improved. The big nasal bumps can be removed and septal deviations can be corrected providing a better nasal airway.

How Should I Correct My Drooping Tip & Hanging Conumella?

Your nose is crowding your upper lip and there are muscles at the bottom of your nose which are pulling your nose downward when smiling.

A small resection of the bottom of your nasal septal cartilage (caudal septum) with a slight angle upward in the distal 1/3 of your caudal septum will accomplish much of the look you desire. 

If you were my patient, I would also add a tip graft to the tip of your nose to elevate it.  This would require minimal surgery and a relatively quick recovery. 

New York has truly amazing rhinoplasty surgeons, therefore you should not have to travel far to find the plastic surgeon you are looking for. 


Rhinoplasty can improve the nasal tip...

Usually the dip of the nasal tip is due to cartilage that is too long and unsupported, or simply an enlargement of the underside of the tip cartilage. During rhinoplasty, the tip can be lifted and excess cartilage can be trimmed to create the shape you want. There is also a small muscle that pulls the nose down when smiling and that can be reduced during the rhinoplasty. Be sure to consult with a rhinoplasty specialist when ready to undergo surgery.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 187 reviews

How should I correct my drooping tip / hanging columella?

There are ways to correct the problem that you feel is present in your nose. For the best way to proceed, I recommend consulting with doctors in person. Although you did provide images, the best way to assess you is by seeing you face to face. All your questions can be answered thoroughly this way.
Best of luck,
Dr. Ali Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 188 reviews

Rhinoplasty?

Your photos do not give me information. It does not look from the 3/4's view that you have a hanging columella.  A true profile would help to se if your tip plunges.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Nasal tip droop

The structure of the nose between the nostrils is called the collumela. The stronger this structure is, the better the nasal tip stays supported. If it's weak , the tip will fall wnen smiling and when touched by your finger. Modern rhinoplasty techniques should emphasize strengthening this structure, usually accomplished by placing a collumela strut.

Thomas Romo, III, MD, FACS
Manhattan Facial Plastic Surgeon
4.9 out of 5 stars 48 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.