What can be done to make my hanging columella less noticeable while not creating more space between my nose and mouth? (photos)

Question

I feel if my philtrum was any longer it would throw off my facial harmony and I would become self conscious of it. I don't think I could get a surgical lip lift due to having ehlers danlos and increased scarring due to that and I do not want to have to get consistent lip injections as an alternative. But my nostril size and the way it dips upsets me- especially side profile. I also want to address the bulbous tip.but really want to avoid upturned snub or Barbie nose as well. Is this possible?

Eric M. Joseph, MD · Answer

The best advice I could give is to research your potential rhinoplasty surgeons carefully. I believe that your issues may be addressed with surgery, depending on your examination, and the expertise of your surgeon will be critical. Thank you for your question. Sincerely, Dr Joseph

Zoran Potparic, MD · Answer

Considering your history of Ehlers-Danlos Sy it may be in your best interest to consider non-surgical rhinoplasty with fillers. Injection of the filler into membranous septum/columella and tip of the nose may give you enough change regarding tip elevation, projection and shaping. You should look for a board certified plastic surgeon with experience in this procedure. Good luck.

Anil R. Shah, MD · Answer

Hi Scarlet, Hope this message finds you well. It is possible to achieve a smaller tip, reduce your nostrils, while maintaining the current angle of your nose. I would love have you to the office for a consultation to show you what that would look like. We also office virtual consultations for out of town patients. Hope to connect soon.

Gary M. Horndeski, MD · Answer

I recommend a rhinoplasty. Your dorsum needs to be straightened, the tip needs to be redefined and the nasal columella angle needs to be increased. Also, your nose appears to be leaning towards one side and you may also need a septoplasty done at the same time.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. Your hanging columella could be addressed at the same time. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

What can be done to make my hanging columella less noticeable while not creating more space between my nose and mouth? (photos)

Answers (5)