Why the columella looks long and how to reposition the nasal tip cartilage

Hello, I am Dr. Peter C. Kang.

Today, I would like to share the case of a patient who visited our clinic concerned about a crooked nose and an elongated columella. She was bothered by the columella hanging down excessively in profile view and also wanted to correct the deviation throughout the entire nose.

• 5 years ago: Filler procedure (dissolved before surgery, remaining filler removed during surgery)

• 2 years ago: Silicone implant + ear cartilage surgery

• Correction of deviated nose

• Goal: Reduce the columella (correct the elongated columella)

• Natural profile line

1. Tip cartilage repositioning using autologous rib cartilage

• Removal of existing ear cartilage and replacement with autologous rib cartilage

• Reinforcement of the nasal tip support framework

• Adjustment of columellar length by repositioning the cartilage

2. Correction of the crooked nose

• Realignment of the central nasal axis through septal correction

• Securing symmetry along the nasal bridge line

3. Nasolabial angle correction

• Angle adjustment that naturally elevates the columella

• Reduction of columellar show in profile view

• Establishment of a balanced relationship between the nose and lips

1. Frontal changes

• The crooked nose was aligned along the midline

• Improvement toward a more defined and refined nasal tip

• Improved overall nasal symmetry

2. Profile changes

• Naturally shortened appearance of the previously elongated columella

• A refined profile line through nasolabial angle correction

• Improved balance between the nasal tip and the lips

• An overall soft and feminine profile

3. Nostril changes

• Improvement in nostril shape through adjustment of columellar length

• A more balanced appearance viewed from below

An elongated columella is a concern shared by many patients. When the columella hangs down excessively in profile view, the nose can look drooping or resemble an arrow nose, which frequently causes dissatisfaction.

In this type of case, we naturally adjusted the length of the columella by repositioning the nasal tip cartilage using autologous rib cartilage. Rather than simply trimming the columella, we repositioned the tip cartilage and readjusted its angle to correct the nasolabial angle, achieving a natural and balanced result.

In particular, replacing the previously used ear cartilage with autologous rib cartilage reinforced the support of the nasal tip. This plays an important role in maintaining the effect of the nasolabial angle correction over time. By simultaneously correcting the crooked nose, symmetry was also improved on the front view. This is a good example of addressing multiple concerns in a single surgery. I hope this case is helpful to anyone concerned about an elongated columella or looking to correct a crooked nose.

This was Dr. Peter C. Kang. Thank you.

#closedrhinoplasty #closedrevisionrhinoplasty #crookednosecorrection #nasolabialanglecorrection #columellacorrection #autologousribcartilage #tiprhinoplasty #female rhinoplasty