Can the nasal spine be removed? (Photo)

Question

I found that the beginning of my columella start to low. I would like that the beginning of my columella start more high at the level of the nostrils. What can a surgeon can do to raise the beginning of the columella ? Does the nasal spine should be reduce ? Thanks for your help What can

Oakley Smith, MD, FRCSC · Answer

The nasal spine is the bony spur at the bottom of your nose where the columella (the fleshy part between the nostrils) joins the upper lip. It can certainly be removed at surgery. The indication is when there's too much fullness or show at this juncture between nose and lip. Usually it is done after other resections of cartilage and soft tissue haven't solved the issue. The picture suggests more than just bony removal will be required.

Kenneth Hughes, MD · Answer

You can have a more refined nose that is
 natural in appearance.  I perform these surgeries with closed technique
 to preserve the structure of the nose and minimize visible scarring.Kenneth Hughes, MDLos Angeles, CA

Bahman Guyuron, MD · Answer

The anterior nasal spine can be reduced if there is significant fullness at the junction of the nose and the lip (columella-lip junction). One has to be extremely careful about reduction of the nasal spine on noses that have underprojected tip since reduction of the nasal spine will reduce the tip support and may necessitate adding more support which can be done in a variety of ways. Additionally, reduction of nasal spine will make the lip to look longer and narrow the angle between the columella and the lip. These dynamic changes are the reason that rhinoplasty is the most difficult procedure in plastic surgery and understanding of these dynamics is essential to producing pleasing outcomes. When the columella is hanging it can be retracted by riding it on the caudal septum (overlapping the cartilages) or by removing a small portion of the septum in a rectangular shape, along with removal of proportional amount of the redundant nose lining.

John Michael Thomassen, MD · Answer

You may have increased columellar show from the photo.  To treat this, excision of membranous septum or cartilaginous septum or suspending the medial crura more cephalad can correct this.  The nasal spine is usually deeper than this and does not need contouring.  Best wishes!

Nima Shemirani, MD · Answer

Dear castiel001,Yes, you can remove a little of the nasal spine to make room for the columellaYou can also remove a small piece of the septum to accomplish the same goalAn exam would be helpful to see where the issue is and what can be done about itBest,Nima Shemirani

Darryl J. Blinski, MD · Answer

Sure it can but that will NOT raise the columella as requested. Additional steps are needed. Best to seek IN PERSON explanations from boarded rhinoplasty surgeons in your area...

Steven Wallach, MD · Answer

If your columella is hanging ( which is hard to tell from the photo), the caudal septum can be trimmed and if it is the nasal spine then that can be reduced as well.

William Portuese, MD · Answer

A columellar plasty can be performed as a stand-alone procedure, or as part of a rhinoplasty procedure. This involves trimming back excess caudal septum and skin on both sides of the inside of the columella. Occasionally a small portion of the nasal spine can also be resected  when it is extremely prominent. For many examples of columellar plasty, please see the link below

Can the nasal spine be removed? (Photo)

Answers (8)

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