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

If so will removing/reducing it shorten the vertical height of the nose and maybe give you a longer upper lip?

Doctor Answers 6

Reduction of Nasal Spine and Its Effects on Nasal Appearance

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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.

Regarding having Large Prominent Nasal Spine without Tethered Upper Lip

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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.

Alberto Di Giuseppe, MBBS
London Plastic Surgeon

The Nasal Spine may influence the appearance of your lip

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  • 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


Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon

Prominent nasal spine can deform the nose

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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.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon

Prominent Nasal Spine and Caudal Septum Affecting Apparent Lip Length

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    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.

Gummy smile??

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 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

Gary R. Culbertson, MD
Columbia Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.