Would I need a rhinoplasty if I want to make changes to my columella or are there less invasive options? (photos)

Question

Considering a rhinoplasty to adjust the bottom of my nose which I believe is called the columella. Would I need a full rhinoplasty if that is all I would like modified or could I potentially have a less invasive procedure? What would be involved? I’m happy with the bone/top half of my nose, just would like some work on the bottom half. Thanks!

Randal Haworth, MD, FACS · Answer

It is possible to have a less invasive procedure to address only the columella without undergoing a full rhinoplasty. There are several surgical techniques available to modify the columella, depending on the specific concerns you have with its appearance.

One option is a columellar strut graft, which involves using a small piece of cartilage to support and reshape the columella. This can be a good option if your main concern is the shape or position of the columella, as it can help to improve symmetry and balance with the rest of your nose.

Another option is a columellar trim or resection, which involves removing a small portion of the columella to adjust the overall length or projection of the nose. This may be a good option if you feel that the columella is too long or droopy.

It's important to consult with a board-certified plastic surgeon who specializes in rhinoplasty to determine the best approach for your specific needs. They can evaluate your nasal anatomy, discuss your concerns, and recommend the most appropriate procedure to achieve your desired results.

I hope this helps,
best of luck !

Oakley Smith, MD, FRCSC · Answer

You can have a rhinoplasty surgery limited to the tip an columella areas of your nose to address your concerns. The surgical approach will be the same but the surgery itself is less invasive than a full rhinoplasty.

Andrew Miller, MD · Answer

Based on your photos, you are a great candidate for rhinoplasty. If you are not concerned about the bump, you can have just a tip rhinoplasty to improve the columella and projection. But taking the bump down a bit would look nice as well. Be sure to see rhinoplasty experts for consultation.

Gianfranco Frojo, MD · Answer

I believe that you would benefit from an open rhinoplasty to help with the goals you have described. An open rhinoplasty would allow the skin to be reduced and redrape appropriately over the reduced columellar size/projection/length. I would highly recommend seeing a board-eligible of board-certified plastic surgeon with rhinoplasty experience, particularly one with 3D imaging that is capable of simulating your surgery so you can be on the same page regarding the outcome. Best of luck.

Zoran Potparic, MD · Answer

Based on these photos, there seem to be several issues that could be improved on your nose, beside hanging columella? It would be in your best 9iinterest to discuss this issue in person with a board certified plastic surgeon, expert in rhinoplasty. Good luck.

Thomas Trevisani, MD · Answer

When treating one element of the nose- all other aspects of the nose need to be addressed in order to achieve the best result. Based on your limited photos- you appear to be a good candidate for Rhinoplasty preferably performed through a closed technique. I suggest that you seek an experienced Board Certified PS

Nima Shemirani, MD · Answer

Hi @T1308. I recommend seeing an experrt rhinoplasty specialist for an in person examination. There are several options for you that can be determined after examination. Best of luck to you, Dr. Nima!

Ronald J. Edelson, MD · Answer

You have what is known as a hanging columella. The reason is that the lower end of the septal cartilage is too long. It just needs to be cut back a few millimeters. Very simple. Could be done under local anesthesia. There are other more complicated techniques some of which involve cartilage grafting. Keep  this simple

Eric M. Joseph, MD · Answer

Based on your photos, you appear to have a profile hump, a long nasal appearance, and excessive show from a hanging columella. Depending on your examination, Rhinoplasty surgery may be considered for achieving repair of you're hanging columella, along with hump reduction for a less distracting, and more feminine nasal appearance. Consider consulting with several reputable rhinoplasty specialists so you could see what might be best for you moving forward. Sincerely Dr Joseph

Tanveer Janjua, MD · Answer

A long columella can be reduced under local anesthesia in the office. It is quick and no down time. 
Watch the video below to see how it is done. 
Regards
Dr. J

Would I need a rhinoplasty if I want to make changes to my columella or are there less invasive options? (photos)

Answers (19)

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