In the before picture, you can see some white marks in the middle of her
dorsum that are reflections from the flash, right where the hump was.
The marks are crooked, indicating that her nose was a little crooked
in that area before surgery. I mentioned in the section on nasal
reconstruction that correcting a crooked nose is one of the hardest changes to
make in rhinoplasty. However, if the crooked area is small, and if it's on the hump, sometimes
simply removing the hump removes the crookedness entirely.
We also know that her nose was shortened somewhat during her rhinoplasty,
because we get a better view of her nostrils in the after picture.
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Asymmetry & hanging columella. Interests: Tim Woolford, Julian De Silva, Julian Rowe Jones, Lucian Ion
I am 7 yrs post primary rhinoplasty. I was looking for my slight bump amd bulbous tip to be addressed. Immediately after my cast was removed 1 wk after my op, it was clear I had been left with an asymmetrical and hanging collumella (my natural nose did not have this). Its been 7 yrs & I'd like revision. My main concern is my hanging & aysemetric collumella, I feel my tip is bulbous in comparison to my thin bridge with large projection. I have very thick, oily skin with large pores on my nose.
(Questioner submitted photos)
Dr. Denenberg's answer: It's more than just the columella
It's not just that the columella is hanging, because your columella protrudes downward only a millimeter or two down beyond your nostril edges.
It's that the entire tip of your nose is low, the nose is very long, and best would be to raise the tip, much more than just elevating the columella.
You are correct that the tip is somewhat wide, too.
See the first patient in the attached video -- she has a nose with some similarities to yours.
Link to this question on RealSelf.com