She has a prominent bifidity in her columella. "Bifidity"
means that you can see a dent between the two cartilages that make up the
columella. It's not such an uncommon finding. She probably had it
before her first operation, and it simply wasn't corrected during that first
In this view, you can see more of her nostrils in the before picture.
The nose was tilted up too much, and I attempted to lengthen it during the
revision. A longer nose shows less nostril from the frontal view.
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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