Repositioning of the Nares / Columella?

I read your question and reviewed your photos:

The computer imaging looks attractive. You have fullness of your lower bridge, just above your tip, along with excessive nostril show. You look as though you may have had nasal surgery in the past.

The success of your surgery will depend on your personal history of previous nasal surgery, and the experience of your surgeon. You would require an examination to determine how to approach your concerns.

I hope this is helpful for you.

Regards from NJ.

The relationship of columellar and alar position plays an important role in any great rhinoplasty result. There are a few ways of improving columellar show and/or retracted ala.

Excessive columellar show can be address by:


Repositioning the columellar cartilages upward and overlapping them with the septum in a tongue-in-groove manner

Resecting a portion of septum to allow the columella to retract upward


The ala can be addressed by:


Placing an alar rim graft. This can provide a modest amount of improvement for a retracted alar margin

Totally repositioning the lower lateral crural cartilages in a lower position to bring the alar rim down

In some instances placement of a cartilage/skin composite graft from the ear to the inside of the nostril can help bring the ala down.


I prefer the first 2 methods of treating retracted ala in most cases.

Reducing columellar show (amount of nostril visible) can be done by shortening the septum and lowering the alar (nostril) margins

Your morphed photos suggest full rhinoplasty with tip and profile work, lip enhancement, face and necklift.

As far as your columella goes if it is down due to a long septum then this could be shortened and the columella tucked up. If the rims are retracted then they can be lowered with rim and composite grafts.

I have performed Rhinoplasty for over 20 years and IMHO, from your picture it would be better to do a columellar tuck than place external incisions along the outside of the nares...which can ctreate unsightly scars.

The columellar show can be corrected by elevating the cartilage within the columella and/or shortenng the septum. Small cartilage grafts can be placed to lower the alar margin. Your photoshopped results show you have reasonable expectations.