Even in cases where the columella appears to hang downward, the orientation of the nasal tip is not always the same. While some records address a long nose, dorsal hump, and drooping tip together, a primary rhinoplasty patient presented with both an upturned nasal tip and a hanging columella at the same time. It is important not to combine the appearance of the columella and the nasal tip into a single concept.
This collection serves as a reference for comparing how much of the columella shows in profile view and how the surrounding lines connect. One original case note details separate plans for elevating a drooping tip and reducing a hanging columella, while also explaining reinforcement for thin skin. By first distinguishing what is drooping downward, one can understand the surgical details more precisely.
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A case where a short, upturned nasal tip and a drooping columella in an unoperated nose were corrected through septal extension. A strut was built using donor rib cartilage and septal cartilage, accompanied by columellar elevation and silicone implant placement.
Preoperative condition · Postoperative record
After 6 previous surgeries, a drooping and tilted columella, crooked nose, and nostril asymmetry were stabilized through a closed approach using autologous rib cartilage reinforcement, lateral osteotomy, and columellar alignment correction.
Preoperative condition · Postoperative record
Following prior surgery with a silicone implant and ear cartilage, the patient presented with a long, drooping columella and a crooked nose. The ear cartilage was replaced with autologous rib cartilage, the nasolabial angle was adjusted, and septal correction was performed.
Preoperative condition · Postoperative record
A case of a drooping columella, crooked nose, and nostril show following prior filler, Misko, and silicone rhinoplasty. Autologous rib cartilage reconstruction and alar rim grafts were performed after implant removal.
Preoperative condition · Postoperative record
This is a case where the nasal bones, septum, and keystone area were damaged after repeated surgeries, causing nasal obstruction due to nasal valve stenosis. Autologous rib cartilage was used to reconstruct the nasal support structure and nasal valve, while correcting bridge depression and asymmetry.
Preoperative condition
For a patient presenting with a severely drooping columella, an arrow nose, and nostril asymmetry after previous surgeries, autologous rib cartilage septal extension and lower lateral cartilage repositioning were performed to improve tip drooping and asymmetry.
Preoperative condition · Postoperative record
A case where a crooked nasal bone and drooping bulbous tip remaining after previous dorsal hump correction were straightened through lateral osteotomy, septal extension using autologous rib cartilage, hump rasping, and rhinitis surgery.
Preoperative condition · Postoperative record
For a patient whose nose became crooked and drooped due to partial resorption of previously placed donor rib cartilage, we removed the absorbed cartilage and performed septal reconstruction and deviated septum correction using autologous rib cartilage.
Preoperative condition
Correction of a crooked nose and bulbous tip following fracture reduction and multiple prior rhinoplasties using autologous rib cartilage septal extension, lateral osteotomy, nasal sill reduction, and nasolabial angle correction.
Postoperative record
Dorsum depression and nasal obstruction following previous dorsal hump reduction were corrected with inferior turbinate reduction, lateral osteotomy, autologous rib cartilage extension, and implant placement.
Preoperative condition
A case of a 22-year-old female patient with a long nose, a dorsal hump, and rhinitis symptoms, who underwent septal extension, hump reduction, lateral osteotomy, and silicone implant insertion.
Preoperative condition
This was a case involving a blunt nasal tip, a high starting point at the glabella, and mesh foreign material following a previous surgery. Four pieces of mesh were removed, and septal reconstruction and extension were performed using autologous rib cartilage.
Preoperative condition
A case presenting facial asymmetry alongside a dorsal hump, a crooked nose, and a drooping columella. Using a closed approach, nasal tip correction with autologous rib cartilage, dorsal hump reduction, lateral osteotomy, and silicone implant placement were performed.
Preoperative condition · Postoperative record
This is a case of previous surgery resulting in a deviated nasal bridge, an upturned nasal tip, nasolabial angle issues, and nasal obstruction. Using a closed approach with autologous rib cartilage, septal deviation correction, septal extension, and lateral osteotomy were performed.
Preoperative condition
A contracted nose with cartilage damage caused by MRSA infection was reconstructed using a closed approach with autologous rib cartilage septal reconstruction and extension, osteotomy, and lower lateral cartilage correction.
Preoperative condition
To address a contracted and upturned nose with nostril asymmetry resulting from inflammation and implant removal, stem cell therapy was performed first, followed by autologous rib cartilage septal extension, alar rim grafting, and silicone nasal bridge augmentation.
Preoperative condition
For a drooping arrow nose, dorsal hump, deviated septum, and hypertrophic rhinitis, lateral osteotomy, autologous septal extension graft, and inferior turbinate resection were performed using a closed approach.
Preoperative condition · Postoperative record
A case of a nose that appeared long with nostril asymmetry after two prior nasal surgeries, corrected using a closed approach with silicone implant replacement, autologous rib cartilage septal extension, and adjustment of the radix.
Preoperative condition · Postoperative record
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In the surgical records, they are documented as findings in different anatomical areas. One primary surgery case explains that while the nasal tip was upturned with excessive nostril show, the columella hung downward. Therefore, assuming that the nasal tip faces the same direction based solely on columellar hanging would contradict the documented findings. Please review the front and profile descriptions in the original post together.
Yes. A case note addressing a long nose and a dorsal hump detailed separate plans to support and elevate the nasal tip with autologous rib cartilage and to reduce the hanging columella. Because the skin was thin and cartilage was showing through, a separate skin reinforcement plan was also included. This serves as an example where the nasal tip, columella, and skin were addressed as distinct components within a single profile view.
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