Can A Hanging Columella Be Corrected?

Q: Dr. Eppley, I had a combined rhinoplasty and sinus surgery nearly three years ago. The rhinoplasty result turned out to not be so good as the middle part of my nose was too pinched inward. I then underwent a revision about a year ago where cartilage was taken from ear to build up the middle part of my nose. I am still left with one problem that has not been corrected. I have a hanging columella with a slight outward rotation of the cartilage. Is it repairable? What is the cost and since my previous surgery was covered by insurance would the revision be as well?

 A: A hanging columella deformity can occur for two reasons. The underlying caudal end of the septal cartilage may have been adequately reduced or overresected, leaving excess mucosa and skin ‘hanging’ off the cartilage. This usually leaves an outward curve of soft tissue from below the tip down to the base of the nose. The other type of hanging columella, which is not a true columella deformity but may initially appear so, is when the infratip lobular cartilage is too prominent and pushes outward on the columellar skin. This creates more of a ‘hard’ hanging columella because it is composed of cartilage.

Either way, both types of hanging columellas can be corrected fairly easily a minor revisional rhinoplasty procedure.. This type of nasal problem would not be covered by insurance as it is a cosmetic problem, regardless if the original nose procedure was covered by insurance. The cost would be influenced as to whether it is done in the office under local anesthesia or in the operating room under some form of anesthesia.

Dr. Barry Eppley

Indianapolis, Indiana