Many people have nostrils that are positioned considerably above their columella — the tissue separating the right and left sides of the nose. This condition is known as a hanging columella, or alarcolumellar disproportion. The columella can be shaped in various ways — it can be hanging, retracted, flaring or wide. Many look to nasal surgery to fix these aesthetic deformities, but the approach to fixing a hanging columella depends on how and why the lower portion of the nose came to hang in the first place.
Hanging columellas often occur naturally in patients, and are the result of nasal growth. A columella can hang because of a disproportionately long septum or the positioning and orientation of the columellar cartilages. Aside from natural occurrences, hanging columellas can be an outcome from a mistake in a previous rhinoplasty. This can occur from excessive cartilage resection or nasal retraction. Columellar struts can protrude too far as well, disproportionately projecting the new nasal tip and affecting the columella’s aesthetic. During surgical evaluation, if the patient has previously had rhinoplasty, special consideration will be made to assess the proper procedure necessary.
If you have recently had nasal surgery, swelling in the tip or columella may be causing the hanging columella, so consult with your plastic surgeon before contemplating another surgical procedure. Rhinoplasty swelling can occur for many weeks following the initial procedure, so consult with your plastic surgeon about ways to decrease your inflammation.
HANGING COLUMELLAS PROCEDURE
The columelloplasty can be performed alone without altering any other components of the nose. A hanging columella can be adjusted by trimming the membranous columella and cartilaginous columella. If the cartilage is already retracted, then the surgery will only include a membranous removal. This trimming will tuck the columella inward so it will no longer hang. Take a look below to see an example patient’s profile before and after the columelloplasty.
Though no surgery is exactly the same, the goal of the hanging columella procedure is to improve the relationship between the columella and the nostrils. By re-shaping the columella, the nose can appear proportionate from both a frontal and profile view, and the columella will align with the rest of the nasal and facial architecture.
A columelloplasty typically costs less than a full rhinoplasty procedure. Depending on the extent of the surgery, columella procedures can range between $2,000 and $5,000.
HANGING COLUMELLA RECOVERY
The columelloplasty is a closed approach, meaning that the incisions in the nose are on the inside of the nostrils/nasal area. The sutures from this surgery are dissolvable and will remain intact for about one week after surgery.
There are no bandages or removal of sutures after this type of procedure. There may be minor swelling, so it may take several weeks to see the final result. However, the extent of the swelling is nothing like that of a full rhinoplasty, so the recovery will be fairly minimal.
The columella provides architectural support to the remainder of the nose, and is an aesthetic element to the nasal tip. If you think you may have a hanging columella and desire a nasal adjustment, consult an experienced plastic surgeon for a proper examination.