Correction of true hanging columella using medial crural tuck-up technique

The nasal tip and columella are the two main key components that affect the results of a successful and aesthetically satisfactory rhinoplasty. A true hanging columella is a deformity in which the caudal border of the columella has a downward bowing appearance due to disproportion between the ala nasi and the columella, which is usually congenital. In the management of this challenging deformity, a thorough understanding and consideration of tip dynamics and the anatomical causes address the proper technique to be used. In this study we present our clinical experience with the medial crural tuck-up technique used on 53 consecutive patients with a true hanging columella.

A total of 1,421 patients underwent rhinoplasty between January 2005 and September 2011; 53 of those patients (age range=20-37 years; mean=27.3 years), who underwent this technique, were involved in the study. Thirty-eight patients were followed up for more than 1 year.

The results were evaluated by comparing postoperative photos with preoperative photographic documentation. The appearance of the nasal tip and columella remained fine and stable over the 1 year of follow-up.

Despite its limitation of applicability in secondary cases, the advantages of this technique are that it does not require conchal or costal cartilage and the desired tip rotation and projection can be done with ease.

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