1101 MADISON ST #1280 SEATTLE, WASHINGTON 98104 | (206) 624-6200
The Facial Plastic Surgery Center
Dr William Portuese - Board Certified Facial Plastic Surgeon

Rhinoplasty for excess columellar show

A rhinoplasty, and more specifically a columellar-plasty can be performed when patients have a hanging columella. The hanging columella is usually composed of both bone and cartilage. The cartilage component is the most inferior caudal extension of this nasal septum. A small amount of the caudal septum is composed of the bony nasal spine. Cartilage, bone and skin all need to be adressed to reduce the hanging columella. The columella angle with relationship to the upper lip can also be adjusted upwards or downwards depending upon the angulation of the cartilage removed. To lift the tip, more cartilage and skin is removed from the most superior portion of the columella. To bring the tip downwards requires more cartilage and bone along the nasal spine brought in to cantilever the tip back downwards. Skin is also removed from both sides of the columella as well to tuck the entire septum upwards and inwards. It is also important to release the depressor septi ligament if present, which prevents the tip from drooping when patients smile or talk. Releasing the depressor septi ligament will also prevent the skin from bunching up and showing even more columellar show upon animation. To some degree, the tip can also be lifted at that time if there is a drooping tip present. It is also important to narrow the nasal tip cartilages at the same time if needed to balance with the new columella. Sutures used to close the incision on both sides of the columella are catgut sutures which are dissolvable and fall out in about a week. A columella-plasty can be performed as a stand-alone procedure or it as a component of a full rhinoplasty procedure, depending upon the patient’s desires. Dr. William Portuese is a board certified facial plastic surgeon practicing in Seattle Washington and is the medical director at the Seattle Rhinoplasty Center.

Excess columellar show, also known as a high or visible columella, can create an imbalanced appearance and draw unwanted attention to the nose. Rhinoplasty offers a transformative solution to correct this concern, restoring harmony and proportion to the face. By addressing the excess columellar show through a customized rhinoplasty procedure, individuals can achieve a more aesthetically pleasing nasal profile.

Understanding Excess Columellar Show:

Excess columellar show refers to the increased visibility or prominence of the columella, the strip of skin between the nostrils. This condition can make the nose appear disproportionately long, disrupt facial harmony, and impact overall facial aesthetics. Rhinoplasty specifically targets this issue by repositioning and refining the nasal structures to create a balanced and natural-looking result.

Customized Surgical Approach:

Rhinoplasty for excess columellar show involves a customized surgical approach tailored to the individual’s unique anatomy and desired outcome. A skilled facial plastic surgeon will evaluate the nose’s proportions, the height of the columella, and the underlying nasal structures during a thorough consultation. Based on this assessment, the surgeon will develop a personalized surgical plan to correct the excess columellar show and achieve a harmonious nasal appearance.

Addressing the Nasal Tip and Septum:

The surgical technique for addressing excess columellar show typically involves modifying the nasal tip and septum. The surgeon may employ several techniques, such as tip refinement, cartilage grafting, or nasal tip rotation, to reposition and reshape the nasal tip and columella. In some cases, a septoplasty may be performed to correct any underlying septal deviations that may contribute to the excessive show.

Preserving Nasal Function and Aesthetics:

While addressing the excess columellar show, the preservation of nasal function and aesthetics is a priority. Surgeons aim to maintain proper nasal support and functionality while achieving the desired aesthetic outcome. By ensuring that the nasal structures are properly balanced and proportionate, the surgeon can create a more harmonious appearance while preserving proper breathing and nasal function.

Recovery and Results:

Following rhinoplasty for excess columellar show, patients can expect a recovery period that typically lasts several weeks. Swelling and bruising around the nasal area are common, but they gradually subside over time. Patients are advised to follow post-operative care instructions provided by their surgeon to promote proper healing and minimize potential complications. As the healing process progresses, the final results of the rhinoplasty will become more apparent, revealing a refined and balanced nasal profile with a reduced columellar show.

Consult with a Qualified Facial Plastic Surgeon:

If you are concerned about excess columellar show, it is essential to consult with a qualified facial plastic surgeon experienced in rhinoplasty procedures. During the consultation, the surgeon will assess your nasal anatomy, discuss your goals, and develop a personalized surgical plan tailored to your needs. By choosing a skilled and experienced surgeon, you can ensure that your excess columellar show is addressed with precision, resulting in a more balanced and harmonious nasal profile.

Rhinoplasty for excess columellar show offers a transformative solution to achieve a more balanced and proportionate nasal appearance. Through a customized surgical approach, skilled surgeons can refine and reposition the nasal structures, reducing the prominence of the columella and restoring harmony to the face. Consult with a reputable facial plastic surgeon to discuss your concerns and explore the possibilities of rhinoplasty for excess columellar show, taking the first step towards a more harmonious and aesthetically pleasing nasal profile.

Washington Ambulatory Surgery Center Association Washington State Medical Association American Academy of Facial Plastic and Reconstructive Surgery Real Self