Prominent nasal spine/nasolabial angle - what is achievable with rhinoplasty? (Photos)

Question

My nasolabial angle is not ideal due to my prominent nasal spine . I believe it gives me a beak look. What is achievable with rhinoplasty? How will it affect the upper lip?

Lucian Ion, FRCS · Answer

Thank you for your question and sharing your photographs.

In a rhinoplasty intervention it is possible to reduce the nasal spine as well as the nasal bridge bump.

In general, a reduction on the nasal spine changes the reference plane for assessment of the nose tip projection and makes it appear more prominent. As a result, it would be preferable to reduce slightly the nasal tip projection to produce a balanced appearance of the profile.

If instead of using the lines to describe the changes you would use a computer simulation program, it would help you to appreciate this aspect which can be included with the rhinoplasty intervention.

Randal Haworth, MD, FACS · Answer

The nasolabial angle is formed by two lines, one running from the nasal tip to the area above the upper lip and the other from the upper lip to the base of the nose where the nostrils are separated. The extent of this angle can be affected by the projection of the nose and the rotation of the nose tip.

An aesthetically pleasing nasolabial angle is typically around 110 degrees. An angle greater than 130 degrees is considered obtuse, while an angle of 90 degrees or less is considered acute.

Elevating the tip and reducing the caudal membranous and cartilaginous septum can be effective in correcting any acute angle to the lip, which seems to be your case based on the pictures you provided.

A rhinoplasty could correct the nasal spine as well.

I recommend to consult with an expert in rhinoplasty for the best results.

I hope this helps,

Best of luck !

Randal Haworth

Oakley Smith, MD, FRCSC · Answer

Hello,
The changes you highlighted in the picture are achievable with rhinoplasty surgery. The nasolabial angle can be made deeper and that can make your upper lip to appear slightly longer. The hump can be removed to give the bridge straight or slightly curved appearance.

Zoran Potparic, MD · Answer

Based on these photos, you seem to be a good candidate for rhinoplasty. In person consultation, or teleconference to start, with board certified plastic surgeon, expert in rhinoplasty, possibly 3D simulation, is recommended. Good luck.

Selcuk Inanli, MD · Answer

Hello! First of al thank you for your question.I have evaluated your case regarding the information you provided and your photos.I can recommend you a rhinoplasty surgery, it will make your nose more straight and align your columella right under your nostrils.

Ronald Schuster, MD · Answer

The fullness at the junction of the nose and upper lip can be caused by a few things. A prominent anterior nasal spine is possible but not as frequent as you might think. You should be able to feel the hard bone protruding. More frequently it is the caudal septum which is too long. Finally, the tip might be pulled too far forward causing. Tenting of the skin. All are easily fixed with rhinoplasty. This is where a good exam is really needed. Good luck.

Eric M. Joseph, MD · Answer

Based on your photo, I agree that your anterior nasal spine is causing a " tension nose deformity." I see that you also have a dorsal hump. These issues are commonly addressed during rhinoplasty surgery. Consider consulting with several reputable rhinoplasty specialists that offer computer imaging so you could see what might be best for you moving forward. Hope this helps! Dr Joseph

Ronald J. Edelson, MD · Answer

Some surgeons refer to this as a tension nose. There is a tendency in cases such as yours to leave the nose too large. Also when done well it will relieve some of the tightness if your upper lip.

Behrad Elmiyeh, MBBS, MRCS, FRCS (ORL HNS) · Answer

Thank you for your questions and for sharing your photographs.
Rhinoplasty is about improving aesthetic appearance of a nose. You are correct, you have a prominent nasal spine and a dorsal nasal hump both of which can be addressed with surgery.

I would suggest that you consult with an expert rhinoplasty surgeon and discuss what you do and do not like about your nose.

You should expect a full detailed examination of your nose to assess your nasal skin, cartilage, bony structures, and your nasal airway/ breathing. This will allow the surgeon to evaluate your nasal appearance and its relation to your facial features.

The use of manipulated (morphed) digital clinical photography provides a platform for discussion as to your desires and expectations. Such images are not a guarantee of exact results, but a great tool to ensure that you and your surgeon are on the same wavelength.
Only then, you would be able to have a full discussion about the benefits vs risks of your surgery and to make an informed decision.
Best wishes,

Robert Ciardullo, MD · Answer

Prominent nasal spine, tethered upper lip, dorsal hump, and beak like profile: you have a gradual angle between the base of your nose and your upper lip. This angle is called the nasolabial angle. In some cases this ill-defined angle which you have is due to a prominent nasal spine, which is a bony structure. In some cases it is due to a shortage of soft tissue between the nose and the upper lip creating a tightness between these two structures and makes one pull on the other. This phenomenon is called a tethered lip. In other words your nose with certain expressions may pull up on your lip and with other expressions your lip may pull down your nose. The beak like profile which you referred to is caused more by the dorsal hump then by the tethered lip. A Rhinoplasty in your case would consist of removal of the dorsal hump and correction to the extent possible of the tethered lip.

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