This can be accomplished under local anesthesia with a relatively minor procedure. This is not a simple procedure but is relatively minor in the hands of a rhinoplasty surgeon.
Thank you for the pictures and your questions. In rhinoplasty, the more times the nose has been operated, the more difficult modifications become. The hanging columella is a problem in the tip cartilages. In your case, it looks like these are bowed outward. There are more or less involved ways of dealing with this -- from shaving the front of the cartilages to repositioning them more posteriorly. In some cases, tip work can be done under local anesthesia in the office. This is very patient-specific, however. Please visit with your surgeon to discuss your specific case.