I want to get my hanging columella fixed. What would you recommend? (photos)

There are patients who are candidate to correct a hanging columella, but usually after they have already had a previous rhinoplasty.  On side view 2or3 mm of columella should show.  It is a simple procedure which can be performed under local anesthesia.  Yours actually isn't that bad, but it could be corrected easily by cutting out the extra cartilage which is holding the columella down.

Hanging columella is a common issue that is a result of the tip cartilage and/or the septum being pushed down excessively below the nostril. Typically we would want to only have a small area showing (columellar show should be approximately 2-3 millimeters). The treatment is done through open or closed rhinoplasty that repositions the cartilage in the appropriate location. Initially recovery peripd is 7-10 days but final results may take 1-2 years. 

I agree with many of my colleagues answers. The only point I will add is that in addition to your columella hanging down your nostrils are slightly retracted. The best result often requires pulling the collumella up as well as adding small cartilage grafts called rim grafts to support the nostril edges and subtly push them downward. Stephen Weber MD, FACS Denver Facial Plastic Surgeon

   This procedure is easy to undergo, and the recovery will be much easier than a full rhinoplasty.  The incision can be hidden.Kenneth Hughes, MDLos Angeles, CA

Repair of a hanging columella can be done under local anesthesia and involves removal of a piece of th septum. Your columella does not appear to be hanging so I need better photos. 

The technique to reduce this is as described by my colleagues.  It is a two week healing period and of course there will be swelling that can take a few months to fully subside. This is something that could be done in most casses under local anesthesia to help keep the costs down.  Fees will vary because it is not a rhinoplasty but just a portion of your nose that is being done.  

 To reduce the hanging columella, a columellar-plasty is performed. This  procedure involves making 2 incisions on the inside of the nose  and trimming  excess skin on the inside of the columella along with cartilage from the caudal septum. The incisions take a few weeks to heal although there is only minimal swelling noted from the outside of the nose since all the incisions are internally. The price for a columellar platy is less than a full rhinoplasty.  Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features. A columellar plasty can be performed independently or as part of a full rhinoplasty. For many examples of a columellar plasty, please see the link below

Yes this can be done under local. A poper exam needs to be done first. The photos are not adequate. Best to you

Though the existing photo is not actually ideal for assessment, your nose appear relatively long with bulbous tip and apparent hanging columella on front view. This is further accentuated by your weak chin. If you are not contemplating for chin augmentation, I would rather shorten your nose slightly and correct your bulbous tip. I understand and respect your desire to correct only the hanging columella but doing this alone will actually make your bulbous tip look worse.

A review of your pictures indicate a mild hanging columella and a wide nasal tip. A week chin also accentuates the nasal appearance. The columella can be shortened or lifted with a mild shaving of the end of the septal cartilage (the caudal edge), a mild resection of the membranous septum (the skin between the septum and the columella), trimming the feet of the medial crus (cartilage that sticks out into the nostril) or thinning the width of the medial crus cartilage. This surgery can easily be performed under oral or IV sedation and local injection (or with general anesthesia at a higher cost). If no tip or bridge work is done, recovery is shortened and without discomfort, bruising, and minimal swelling. The cost is probably less than $2000. I would like to see you consider narrowing your tip and increasing your chin projection with a chin implant, which would balance your facial proportions, and make the entire nose look less conspicuous. A computer imaging session with an experienced cosmetic nasal surgeon should give a realistic expectation of your results.