Hanging Columellar After Rhinoplasty, What Are My Revision Options?

after having an alar base reduction last yr as a revision procedure ive noticed that although im happy that my nose is narrower at the base that from side on my ala look higher than the columellr and you can see my columella. ps i had another operation last week involving a rib strut. its since then that ive noticed a more hanging collumellar look. can this be revised? can the ala be lowered to hide the hanging look? and can this be done as a local and when?

Doctor Answers 2

Hanging Columella Correction

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There are a number of different ways to correct a hanging columella deformity.  Some are very straightforward and can be done in the office, others far more complex.  What is chosen depends on the cause of the deformity.  As you are only 1 week out from revision surgery, the soonest I would suggest doing anything at all is 1 year.  Your nose will continually change and remodel over this time frame and it will be impossible to know exactly what needs to be done until the nose has stopped changing.

Portland Facial Plastic Surgeon

Hanging columella after rhinoplasty

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With tip rotation and nasal shortening the columella can be out of balance with the nostril and produce too much show from the side view. Ordinarily revision is straightforward as the columella can be raised slightly. It is more difficult to lower the rim of the nostril but for some this too may be worth effort. As you mention a rib graft or strut predictions become complicated as to just what the solution might be. Of course, 'anything' is possible in a revision, though without more information, we can only guess.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

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