Wide Nose w/ Hanging Columella

I am interested in getting a rhinoplasty next month. I do not like the wideness of my nose and would like to make it smaller and thinner. I went to see a surgeon who told me that i have a slight hanging columella and that he could make an incision inside the nose to sew it upwards. and he also said he would do a bilateral sil excision on the sides of the nose to bring them in more. I wanted to know your opinions on what the doctor said. Other doctors advice. Thankyou.

Doctor Answers 11

Nasal surgery must be individualized.

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Of all cosmetic surgery, rhinoplasty requires the most individual planning.  Without seeing your picture, it is impossible for me to know if the recommendations that you have been given are correct.  However, if you are unhappy with the width of the base of your nose, then excision of the tissue around the nasal base, sometimes called Wier excisions, is the correct solution.  If you are concerned about your columella being too low, then this condition can be easily corrected as described to you.  If you are concerned about the advice you have been given, take the time to get a couple more opinions from qualified, board certified plastic surgeons.  Rhinoplasty is such a visual operation, that photographs are really necessary to give you an informed opinion.

Nashville Plastic Surgeon

Nose surgery

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It is difficult to say without seeing you as far as what could be improved with your nose. My goal is to make the nose "blend" into the face, so when someone looks at you, they would not see your nose, either because it is too small or too big or too wide or narrow, but your whole face. This I accomplish by working on the cartilages, bones usually with cuts only inside the nose but I also can narrow the nostrils with cuts on the side. Watch my video!

The Surgical Plan For Rhinoplasty Correction Of A Wide Nose Is The Most Important Step

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You are in the early stages of trying to decide what type of rhinoplasty is best for you. Your small picture is really inadequate to judge your prior recommendations although they are reasonable and not uncommon. Whether that will satisfy your aesthetic concerns of your nose, however, may be a different story. You need to get several plastic surgery opinions and have computer imaging done to determine what really can and cannot be done for your nose. While the operation has to be done well to get a good result, the choice of rhinoplasty operation is even of greater importance. An inadequate operation, no matter how well done, will still not make for a satisfying result.

Wide Nose with Hanging Columella

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As best I can tell after reviewing your small picture, the recommended procedures are probably correct.  Although selecting the right procedures is important, how the work is done is more critical. Make sure that you see results in multiple nose similar to yours. A second opinion may be beneficial. 

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews

Correction of a Wide Nose

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One of important things to identify is what exactly you are seeing that contributes to the cosmetic problem. I have found that when a patient wants a smaller or thinner nose, often what they are identifying is different than what I initially identify as the source of their concern. Although your photo is not ideal, looking at it, the width of the base of the nose does not seem excessive. I would take a bit of time to really identify what you don't like. You should be able to point to it with a q-tip. If you can't do this, there is a good chance that you will not be happy with the results of your surgery.

Joseph Campanelli, MD
Portland Facial Plastic Surgeon

Wide Nose w/ Hanging Columella

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The width of the nose can be addressed by alar base approach and the hanging columella can be addressed  through a transfixing incision.You should be able to discuss the approach with your plastic surgeon.

Hanging columell and wide nose

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A wide nose can certainly be narrowed with some sort of alar base excision procedure.  A hanging columella can be treated by removing tissue internally.  An exam would give clarity to the situation.

Wide nose with a hanging columella.

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You need to see an experienced rhinoplasty surgeon who will give you the pros and cons of doing the nose different ways. You need to make sure he does natural, non operated looking noses since you are going to get the type of nose he does. What you mentioned can be fixed easily, but it doesn"t answer the whole question.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Rhinoplasty Surgery may be employed to reduce the width of your nose and correct a hanging columella.

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I read your concern and reviewed the photo of your nose. The photo is too small to judge your candidacy for Rhinoplasty Surgery. A hanging columella is best viewed on a profile photo. The cause can be multifactorial, so there are different ways to improve this. Bilateral sill excisions would be performed to reduce the width of your nostrils.

I hope this is helpful for you.

Regards from NJ:

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 429 reviews

Raising a hanging columella

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The columella can hang lower that looks right making the nose show too much nostril from the side just as the opposite, the columella can be retracted and the nose appear flat across bottom. Rhinoplasty has ample techniques to raise or lower the columella when called for. What your doctor suggests probably makes good sense, photos would help.

Best of luck,


These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.