Wanting a plunging tip/ hanging columella Rhinoplasty Revision. (photos)

It sounds like you have a plunging tip. The nasal tip may be underrotated and typically lacks tip support so that when you smile, the tip plunging is exacerbated and more obvious to you. In many cases, improving tip support with sutures and the addition of cartilage in the form of a columellar strut can significantly improve tip support and help to address your concerns. The columellar-labial angle (angle between the columella and upper lip) and the columellar-lobule angle (angle between the columella and lower half of the tip) may also need subtle adjustment to increase tip rotation and improve tip shape to help correct a hanging or droopy tip. If there is an active depressor septi nasi muscle, this may need to be divided to help decrease dynamic downward movement of the tip during smiling and can also help to decrease the degree of shortening of the upper lip during smiling. All of these changes can help to correct the appearance of a plunding tip.

    I think that your goals are reasonable for revision.  I would perform this in closed fashion.Kenneth Hughes, MDLos Angeles, CA

While nothing can be guaranteed, you appear to be an excellent candidate for revision rhinoplasty, in order to shorten your nose appropriately.  Visit with a surgeon experienced in revision procedures to discuss your goals and he/she can make recommendations for you.

It is difficult to tell form the photos that you posted. It is best to be seen in person to get a better appreciation of your concerns.

The plunging tip is best addressed by releasing the depressor septi ligament that pulls the tip down with animation. Additional cartilage surgery of the nasal tip may be required to lift it. The hanging columella is addressed with a columellar-plasty  which involves trimming back skin and cartilage on the inside of the columella tuck it inwards. For many examples, please see the link below  to our rhinoplasty photo  Gallery