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How can a retracted columella that resulted from a rhinoplasty be fixed? (photos)

I have read septum or rib should be used, but what if septum or a rib is not available for use? 1) What else can be used? 2) Can this be done closed rhinoplasty revision? 3) Why does retraction occur in the first place? 4) The bottom of my nose is very flat. I am missing middle part of my nose from front view & tip from side view. Is that because of retracted columella or something else?

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Dr. Tanveer Janjua, MD
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Dr. Edwin Kwon, MD, FACS
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