Is It Possible to Have a Large Prominent Nasal Spine Without a Tethered Upper Lip? (photo)

    A prominent nasal spine can be reduced to increase apparent lip length and reduce apparent nasal length.  This is usually beneficial from an aesthetic perspective.

By definition, a large anterior nasal spine provides more attachments for the soft tissues of the lip and may, to some degree, always produce a bit of a tethering effect. But reducing the nasal spine will not, in and of itself, reduce the vertical height of the nose and give a longer upper lip. Other rhinoplasty manuevers, such as caudal septal resection, tip rotation and hump reduction are needed to create those nasal effects.

the upper lip is less promiment as tethered by the nasal spine insertion and the depressor septi muscle which goes from upper lip to base of the nostril.
must shorten the lenght of the columella, cut partially the muscle insertion,release partially the anterior nasal spine,and correct the lateral alar cartilagens to allow the tip to rotate upwards.
i believe also hump removal is needed and thus fracture of the nose and dorsal septum reduction as well.

The concepts of shortening the vertical height of the nose and lengthening the lip are complex in that they are proportionally related.

A longer upper lip will not be created just by removing tissue from one location, but the proportions of the nasal tip height and lip length may appear more balanced. 

It is best to have a consultation where the examination and discussion can guide the potential surgical plan based on your interests and the surgeon's expertise. 


Best Wishes

 

A prominnent nasal spine cannot be evaluated in isolation. It has to be considered in relation to all the other surrounding structures. The soft tissue, the lips the surrounding bones.

 Anything is possible. But, having a large boney nasal spine usually results in tethering of the upper lip especially, when smiling. Careful reduction of the nasal spine at the time of a patients rhinoplasty often gets rid of this effect without dramatic changes in the length of the upper lip. Best,

 

Gary R Culbertson, MD, FACS