Different techniques to hide excess columella show? (Photo)

Question

I am going to have a rhinoplasty procedure soon. The surgeon plans to trim my columella as I have excess columella show. I am worried that this will make my nasal tip appear more upturned (greater than 90*), and possibly make my philtrum area appear large. I am happy with the current nasal/lip angle. I would like to know if there is a technique that could be used to hide columella show without cutting the columella? Or should I agree to what the surgeon already has planned for Sx? Thank you

Donald B. Yoo, MD, FACS · Answer

Columellar show is affected by the shape and orientation of the columella in relation to the alar rims.  A number of maneuvers are present to lower the alar rims (rim grafts, LLC repositioning, composite grafts etc) or raise the columella (tongue-in-groove, medial crural overlay, excision of vestibular tissue et cetera et cetera).  As a patient it's usually most effective to choose the surgeon you are comfortable with, get on the same page with him/her in terms of your aesthetic goals, and then defer to him/her with regard to which techniques are the best for your nose.

Vincent N. Zubowicz, MD · Answer

From the photographs it does not appear to me that you have excessive columella show. When the situation does exist it most often is due to the medial foot plates of the lower lateral cartilages. These can be adjusted the time of a conventional rhinoplasty. Sometimes work on the nasal septum or nasal spine may be part of the treatment.

William Portuese, MD · Answer

At the time of the rhinoplasty, the hanging columella can be trimmed accordingly  and excess skin and cartilage can be trimmed to prevent the hanging columella. Depending upon where the incision is made in the columella can determine whether or not surgeons can raise the tip, lower the tip, or simply tuck in the columella from hanging and keep the existing angle. For many examples of columellar-plasty, please see the link and the video below

Sean Freeman, MD · Answer

tito88, hard for any one of us to contradict what a qualified surgeon has recommended after he/she has had the advantage of an exam. However, based solely on your one photo I do not think your columella needs to be addressed. Should you be unsure see several facial plastic specialists and get an exam and ask them in person. Always seek experienced surgeons! Good luck!

Different techniques to hide excess columella show? (Photo)

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Different techniques to hide excess columella show? (Photo)

Answers (4)

Answer: Nose

Answer: Nose

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.