Mar 30

What do you do if too much nostril shows?

The Hanging Columella or Notched Ala: Why you see so much of your columella and septum on profile and how we fix it
The Appearance of Retracted Nostrils or of  Too Much Visible Septum

If you are looking at this blog, you (or someone you hold dear) probably had a rhinoplasty (nose job) sometime in the past and now when you see yourself, especially on profile, all you see is that the middle part of your nose at the bottom (the columella and the septum behind it) is way too visible. Perhaps you have been thinking all this time that your septum shows way too much or that the middle part just seems to hang so low.  You may have seen your original surgeon who said you “healed badly” or you just figured it can’t really be fixed. And unfortunately, frequently this is a problem that even many surgeons find confusing.

So lets’ start at the beginning. Ideally, the distance on profile between the edge of the nostril and the bottom edge of the columella (the middle part of the bottom of your nose) should be no more than a few millimeters. Anything more creates a very unflattering look (some say it looks like a snarl). The main point is that we have to decide whether your septum is “hanging” too low (hanging columella) or your nostril(s) are “pulled” too far back (retracted ala, or alar notching). And making this even more complicated is that sometimes both problems are happening at the same time. Maintaining or re-establishing the integrity of this relationship is critical to ensuring a great new look that lasts over time.

Revision Nose Job profile

Even in the revision setting, correction of nostril retraction and hanging columella can make a world of difference and result in a truly beautiful look

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