I strive to make a nose that doesn't draw attention to itself, but fits with
the rest of the face. Sometimes, a patient's ethnicity or personal tastes
will dictate that I do less during surgery, leaving the nose bigger than most
people would prefer, or doing more, making the nose smaller than the common
vote. Either way is fine, as long as we don't go too far, and as long as
we target the patient's rational wishes as closely as possible.
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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