title: The true hanging columella: simplified diagnosis and treatment using a modified direct approach.
abstract: An imbalance between the alar rim and the columella border can be a disturbing aesthetic deformity. If the cause is a pseudohanging columella, the therapy should be directed to the alar rims. When the deformity is a true hanging columella with unusually wide medial crural cartilages, balance can be restored by excising a C-shaped crescent of cartilage from the cranial border of the medial crura of the alar cartilages in a direct approach. This condition was present in approximately 15 percent of the patients reviewed. The treatment of a true hanging columella adds a subtle beneficial enhancement to the results of a rhinoplasty. The authors describe a simplified diagnostic method and present their experience treating the true hanging columella using a modified "direct approach" through a closed endonasal rhinoplasty.
authors.affiliation: Department of Plastic Surgery at Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: A
authors.initials: A
authors.lastname: Matarasso
authors.forename: S E
authors.initials: SE
authors.lastname: Greer
authors.forename: M T
authors.initials: MT
authors.lastname: Longaker
mesh_terms: D000328:Adult; D004954:Esthetics; D005260:Female; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000002:abnormalities* / Q000601:surgery; D012086:Reoperation; D012225:Rhinoplasty / Q000379:methods*