20th Jan 2025
Drooping and Hanging Nose Surgery Explained
Understanding a Hanging Columella
- A hanging columella is a condition where the columella, the bridge of tissue or cartilage that separates the nostrils, hangs lower or protrudes below the outer ridges of the nostril.
- The columella is the bridge of tissue that separates or lies between the nostrils at the base of the nose.
- If the columella (inner skin/bridge of the nostril) if positioned with 4-mm or more tissue showing below the outer nostril as seen on profile view this is known as increased “columellar show” ie when more than this amount of inner nostril is visible. If you have a nose with a hanging columella we are here to help. Our expert rhinoplasty surgeons can shorten this area to create a less obvious hang between your nostrils, creating a more harmonious nose.
Causes and Anatomy of Nasal Tip Cartilages
A hanging columella can be caused by an overly long septum that pushes the columella downward.
The actual orientation and positioning of the columellar cartilages (medial and intermediate crura) can also cause a hanging columella.
These cartilages can be overly prominent or plunging, leading to a hanging columella. An improperly positioned or overly prominent caudal extension graft following rhinoplasty surgery can lead to a downward push on the columella, resulting in increased columellar show.
Rhinoplasty surgery can also be a cause of a hanging columella. An overly thick plumping graft can also push the columella downward, leading to cosmetic concerns after surgery.
If you have any of the above examples, there is no need to worry, we can help with this.
Pre-Surgery Consultation and Evaluation
Before undergoing a rhinoplasty procedure to correct a hanging columella, it's important to choose a expert rhinoplasty surgeon for a consultation and evaluation. During your consultation, our nose surgeon will assess the patient’s nasal anatomy, discuss your concerns and goals, and determine the best course of treatment.
Your plastic surgeon will examine the patient’s nose, paying particular attention to the columella, nasal tip cartilages, and nasal septum. They will also evaluate the patient’s overall facial structure and proportions to ensure that the rhinoplasty procedure will achieve a balanced and harmonious result.
The consultation is also an opportunity for the patient to ask questions and discuss any concerns they may have about the procedure. They will explain the risks and benefits of the procedure, as well as the expected outcomes and recovery time
Columelloplasty: The Hanging Columella Fixed Nose Surgery
A columelloplasty is a nasal surgery that corrects the protruding tissue that hangs between the nostrils to create a more proportional nose shape. The surgery involves trimming the membranous and cartilaginous tissue to adjust the columella. The procedure may involve repositioning the two nasal tip cartilages to provide better support for the nasal tip and achieve a more balanced appearance. The procedure can improve the proportion between the columella and the nostrils. The surgery can be performed to create a proportionate nose shape from both a frontal and profile view.
Techniques and Benefits
A Columelloplasty surgery technique can be performed independently without altering any other parts of the nose.
Complications from previous rhinoplasty may also contribute to a hanging columella. Revision rhinoplasty surgery can be performed to correct a hanging columella caused by prior surgery.
The surgery can also be performed to correct a hanging columella caused by loss of tip projection and prominent infra-tip lobule.
Alternative Treatments and Non-Surgical Options
While rhinoplasty surgery is often the most effective way to correct a hanging columella, there are alternative treatments and non-surgical options available, however they will not offer a long term option and in most cases do not work. These may include:
- Nasal fillers: Injecting dermal fillers, such as hyaluronic acid or calcium hydroxylapatite, into the nasal tip or columella can help to temporarily improve the appearance of a hanging columella.
- Nasal strips: Adhesive strips can be applied to the nasal bridge or columella to help lift and support the nasal tip.
- Nasal exercises: Certain exercises, such as the “nasal tip lift,” can help to strengthen the nasal muscles and improve the appearance of the nasal tip.
However, it is essential to note that these alternative treatments and non-surgical options may not provide the same level of correction as a rhinoplasty procedure. A qualified rhinoplasty surgeon can help determine the best treatment for each individual patient.
Risks and Complications
Risks and complications of columelloplasty include excessive cartilage resection, alar retraction, and nasal tip ptosis. Damage to the nasal mucosa, the inner lining of the nose, can also be a risk during surgery, potentially leading to complications.
Revision rhinoplasty surgery may be necessary to correct any complications.
It is essential to choose a qualified and experienced rhinoplasty surgeon to minimise the risk of complications.
Post-Surgery Care and Follow-Up
After undergoing a rhinoplasty procedure to correct a hanging columella, it is essential to follow a post-surgery care and follow-up plan to ensure a smooth and successful recovery.
At Kensington Medical your surgeon will provide detailed instructions on how to care for your nose and nasal passages during the recovery period. This may include:
- Applying ice packs to reduce swelling and bruising
- Elevating the head when sleeping to reduce swelling and promote healing
- Avoiding strenuous activities and heavy lifting for a period of time
- Following a post-surgery medication that we may advise
- Attending follow-up post operative appointments with your plastic surgeon to monitor the healing process
We advise to follow a healthy lifestyle, including a balanced diet and regular exercise, to promote healing and support the overall health of the nose and nasal passages.
We book regular follow-up post operative appointments with your surgeon to ensure that the nose is healing properly and that the desired results are being achieved. Your surgeon may also provide additional guidance and support during the recovery period to ensure a successful outcome.
Recovery Time
The recovery time for columelloplasty is generally quick and painless.
After a week you will return to see your plastic surgeon to assess the recovery. The sutures or stitches generally will dissolve unless your surgeon has decided for specific reasons to use removable stitches.
There may be minor swelling or bruising, but this typically resolves on its own within a few days to a week.
Cost and Insurance
The cost of columelloplasty can range between £5,000 to £6,500, depending on the techniques used and the extent of the surgery.
Insurance coverage is generally unlikely and may vary depending on the individual’s policy and the reason for the surgery.
Choosing a Surgeon for Revision Rhinoplasty
It is essential to choose a qualified and experienced surgeon to perform columelloplasty. Finding a plastic surgeon who is on the GMC specialist register or board-certified and has decades of experience in rhinoplasty and columelloplasty is crucial. Visit here to find out about our specialist nose surgeons and revision rhinoplasty surgeons.
Deciding to have a face to face consultation is crucial so that your plastic surgeon can examine your nose, discuss what you are looking to achieve and give advice on the best treatment plan to achieve your goals. To book a consultation or to find out more visit our contact us page for nose procedures.
Realistic Expectations
- It is essential to have realistic expectations when undergoing columelloplasty.
- The surgery can improve the appearance of the nose, but it may not completely eliminate the hanging columella.
- Discuss your expectations with your surgeon to determine the best possible outcome.
Conclusion
Columelloplasty is a specialized nasal surgery that can improve the appearance of a hanging columella. The surgery aims to enhance nasal tip projection, improving the overall aesthetics of the nose. The surgery can be performed to correct a hanging columella caused by prior rhinoplasty surgery or loss of tip projection and prominent infra-tip lobule. It is essential to choose a qualified and experienced surgeon to perform the surgery and to have realistic expectations about the outcome.
To find out more or to book a consultation to see if you are suitable for this procedure please visit our consultation page.
Other related procedures
Alar base reduction or nostril reduction surgery