Fix hanging columella and alarplasty? (Photo)

Your hanging columella and wide nostrils are due to poor tip support.  This can be corrected with local anesthesia and light IV sedation and does not require a general anesthesia.  Cost information is provided after an in person visit.

 The hanging columella can be addressed with a columellar-plasty. This involves trimming back the excess skin and cartilage on the inside of the columella. An alar plasty involves  2 incisions at the base of the nostril sill and excising a portion of skin and sewing the nostrils  into a more narrow position. It is possible to perform these procedures under local anesthesia, however  there are lots of nerve endings in that area of the nose and it is very difficult to get that area completely numbed up to the local anesthetic. Placement of local anesthetic itself will be very painful. In most cases, we perform these procedures under brief general anesthetia for patient safety and comfort. For many examples, please see the video and the link below

Dear jacqlove90, Alar plasty can be performed to reduce the width of the nostrils. In my practice this procedure would be performed with a general anesthesia to provide comfort and ensure safety for the patient. The hanging columella can be addressed at the same time. Best regards, Michael V. Elam, M.D.

Your hanging columella can be lifted but you may need to have cartilage grafts placed to lower your arched nostril rim. The nasal base can be narrowed by excising a small amount of skin with an incision inside in the nasal sill. This can be done with local anesthesia but I would recommend sedation or a light general anesthetic which will make the procedure much more comfortable for you.