Some years ago I approached a surgeon as my upper lip was edentulous and tight when smiling. than a bull horn procedure, he raised the base of my nose. He took a full thickness crescent of skin from the floor of the nasal vestibules and resected the nasal spine lifting the nasal base and sill on closure, slightly rotated my columella. This left me with an unattractive flatter longer lip and significant difficulties in balancing the facial expressions involving the central elevator muscles which are now seem strongly opposed by alae nasalis pulling my nasal base and lip downwards.