Episode 14 – Podcast Show Notes

🎙️ Dr Dan Behind the Scalpel – Episode: Treatment of the Columella

The columella plays a subtle but important role in nasal aesthetics and tip support. In this episode, Dr Dan explains how the columella is assessed in rhinoplasty, what causes it to appear too prominent or retracted, and the surgical techniques used to correct it.

Understanding the balance between the columella, tip, and nostrils is key to achieving a natural and harmonious result.

🔎 What You’ll Learn in This Episode: • What the columella is and how it contributes to nasal shape. • Common columella deformities, including hanging and retracted columella. • How the columella relates to tip position and projection. • Surgical techniques used to adjust columella position. • How small changes in the columella can significantly impact overall nasal aesthetics.

🗝️ Key Notes • The columella is the strip of tissue between the nostrils, formed by the medial crura of the lower lateral cartilages. • Ideal columella show is subtle and balanced when viewed from the side. • Common deformities include: – Hanging columella (excess show below the nostrils) – Retracted columella (not enough visible columella) • These issues are often related to: – Tip cartilage position – Septal length and support – Overall nasal projection • Treatment techniques may include: – Tongue-in-groove to control projection and columella position – Adjustment or repositioning of the medial crura – Septal modification or grafting for support • Overcorrection can lead to unnatural appearance or imbalance with the nasal tip. • Careful assessment of the entire nose — not just the columella — is essential.

💡 Key Takeaway

The columella may be small, but it has a big impact on nasal balance. Successful treatment requires subtle adjustments and a strong understanding of how it interacts with the tip and septum.