Can my columella deformity be corrected? (Photo)

See the "Web reference" link, just below my response. I made some images out of the photos you submitted, to show and explain some important considerations in fixing your tip asymmetry.The main point is that, despite the wild asymmetry at the base of your nose, many features of your tip are very symmetric, and your surgeon must be careful not to harm those symmetries. Those asymmetric cartilages that separate your right from left nostril are the same cartilages that form the size and shape of the tip of your nose. Working on one will affect the other. For example, if the surgeon simply sews the two cartilages at the bottom of your nose to each other, to eliminate the dent, it will probably torque the cartilages and ruin the shape and symmetry of the tip of your nose as seen when someone is looking at you face to face. That dent should be addressed mostly by filling the dent in, probably with crushed cartilage stolen from your septum, and then, as I show in the Web reference link, by trimming the bottom of the left cartilage so that the very bottom of the nose looks more symmetric from the frontal view, and so that the profile view looks shorter and more even.You should understand that these changes require advanced techniques, techniques that most plastic surgeons cannot handle. Be sure to read the section in the "Web reference" link on how to stay out of trouble while searching for a rhinoplasty surgeon.

The cartilage of the nose exists to some degree as standard-- however there are some human beings who have nasal cartilage structure outside of the norm/ average. I see clearly your concerns. This can be addressed surgically. Certain other fine points of your nose may need addressing in order for the final result to be harmonious. It is a challenge for sure- so be sure you have the right Surgeon with years of experience.

Thank you very much for sharing your concerns with us.The harmony between facial parts makes us instinctively recognize the beauty... without knowing it, without defining it, just a perception that surprises and captivates us.In this regard, I suggest perform a Closed Rhinoplasty (without visible scars) to treat the tip, base and nasal bridge.With this procedure you get a delicate nose, better harmonize with your other facial features.Respectfully,Dr. Emmanuel Mallol Cotes.-

Hello and thank you for your question. Based on your photographs, it is possible to perform a columellar strut graft.  This will correct your asymmetry and the two ridges you see. The most important aspect is to find a surgeon you are comfortable with. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.Best wishes and good luck.Richard G. Reish, M.D.Harvard-trained plastic surgeon

Yes you are correct.  You have a condition known as bifid tip with asymmetry where the tip cartilages are not bound together in a symmetrical fashion.  This has also resulted in a deep crease or cleft of the columella skin.  The caudal septum may also be deviated but unable to tell from the photos.  These issues can certainly be improved with rhinoplasty.  The procedure would attempt to restore symmetry to the tip cartilages as well as ensure that they are adequately supported.  Correction of the deep crease in the columella should improve but may not go away completely.  Optimum improvement of the columella crease may require both a columella cartilage graft and a staged (at least several months after rhinoplasty) fractional CO2 laser treatment of the involved columella skin.

 A rhinoplasty procedure can accomplish fixing the cleavage and bifidity which exists between the left and the right lower lateral cartilages of the nasal tip. Suture techniques between the 2 cartilages and a cartilage graft can accomplish straightening and reducing the cleavage.

You have an interesting asymmetry of your lower lateral cartilages. Its hard to say if they are of different lengths or just asymmetrically positioned or both. They are also separated in the columella causing bifidity. It's possible you have some caudal septal deviation as well.This can be corrected with rhinoplasty. It's important that you see a surgeon who is comfortable with correcting this type of deformity as it is not routine.

I might first try injection of HA fillers to depressed columellar areas. Fees in $1,000 ranges...>>>>>>

You have a bifid tip deformity where the lower alar cartilages that make up the tip of the nose down into the columella are not united. This creates a vertical groove down the tip into the columella. That can be corrected by reuniting these cartilage with a possible overlay graft to eliminate the vertical skin groove.