What does it mean when surgeon says he wishes my columella was a bit longer? (Photo)

I had a consultation and the surgeon said that I'd need hump reduction, narrowing of the bridge, and a slight lift to the tip. He said I was a good candidate but that the only thing that is less than ideal is that my columella is not at long as he's wished. He said he won't be using anything to lengthen it thought. Will a slightly shorter one cause a pig like appearance? I don't want to go through with it if so. I don't understand how columella effects projection. Is it upwards or downwards? Thank you!

Doctor Answers 5

Rhinoplasty, some advices:

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.-

Dominican Republic Plastic Surgeon
4.7 out of 5 stars 147 reviews

Columellar Length

It would be best too ask your surgeon what he/she actually meant by that statement. Usually when I have that wish in rhinoplasty it is because I need a longer columella to allow for increased tip projection and to be able to close the columellar incision without undue tension.


Hello and thank you for your question. Based on your photograph, you don't seem to have any issues with your columella. You will benefit from a cephalic rotation of your tip to turn up your tip slightly and a conservative dorsal hump reduction. 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 67 reviews


Not sure what he meant by that. Your columella length looks fine. You need the tip elevated and the hump taken down. Good luck.

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

Columella changes

The columella can be altered during a rhinoplasty. If the columella is hanging it can be lifted. If the columella is retracted it can be brought down.  From the picture that you submitted it appears that you have too much columellar show, however, evaluation of all views would aid in complete analysis.  This will be done when you have your consultation with your doctor.  Regarding the length of the nose, rotating the nose up or down either shortens or lengthens the nose. Nasal length is determined based on the proportions of your face and body and gender.  None of these are apparent on the photo submitted; consultation will determine what is best for you.

Jennifer Parker Porter, MD, FACS
Bethesda Facial Plastic Surgeon
5.0 out of 5 stars 17 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.