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Columellar Hanging

Columellar Hanging: Your nose may be long because of the bottom of your nose. Sometimes this is due to your septum being long. Other times it can be due to your tip cartilages being long. What helps to determine what situation can be based on the side view of your nose.

Open Rhinoplasty Approach Open Rhinoplasty Approach

Analyzing the Hanging Columella: The way to analyze the alae, nostril and columella together is through a side view. First you draw a circle around the opening of the nostril from the side. Then from the most anterior end to the most posterior end, a line is drawn. The nostril rim and the columellar contribution of the nostril make up the superior and inferior portion of the circle. The nostril rim and columellar rim should be about 1-2 mm from the line just decribed. Based on this the nostril rim or columellar rim can be excessively bowed if they are greater than 2 mm. For the nostril rim that are greater than 2mm, there are ways to decrease the nostril rims position as noted also on this page: Asymmetric Nostrils. For the true hanging columella, the columellar rim will lie 2mm beyond and lower than this line described.

Fixing the Hanging Columella: Below is a before and after Image of a Rhinoplasty correction of a Hanging Columella. What follows are pictures demonstrating what we need to do to achieve these results. In the next picture, we show the open approach to Rhinoplasty. The green outlines the septums position. At this point you can determine if the septum is too long and the reason for what is causing the hangling columella. In this case the caudal septum can be reduced to allow the nose to become shorter here (location of the blue arrow). Long and Undesirable Lower Lateral Cartilages: If the reason is determined intraoperatively to be due to tip cartilages (specifically the length and position of the medial crus or legs of the lower lateral cartilages is determined to be too long), you can reduce and restructure these anatomic elements (location of the yellow arrow). You can click here to see more Before and After Rhinoplasty Images.

Before Rhinoplasty Image for Dorsal Hump, Long Nose, Tip Drooping, Tip Bulbousity Before Rhinoplasty Image for Dorsal Hump, Long Nose, Tip Drooping, Tip BulbousityBefore Rhinoplasty Image for Dorsal Hump, Long Nose, Tip Drooping, Tip Bulbousity
Before Rhinoplasty Image for Dorsal Hump, Long Nose, Tip Drooping, Tip Bulbousity