How do you Remove Curve Under Nose? (photo)

I read your concerns and reviewed your profile photo: The curve you're pointing to is called a "tension lip" by some. Anatomically, it is caused by excessive bone or cartilage at the bottom of your septum. This curvature has been typically described as being caused by a large, bony "nasal spine", but in my clinical experience, this curvature is typically caused by septal cartilage. This excessive cartilage or bone may be removed under direct vision during Rhinoplasty Surgery.

I hope this is helpful for you.

Dr. Joseph

this curve is the anterior spine and can be caused by a tension nose  where the tip pulls the skin forward   or 

it may be excessive bone at the base of the nose

it is correctable either way

The curve underneath the nose is composed of skin, bone, and cartilage.  It is called the columella.  When it hangs down too much the skin is trimmed back along with excess bone and cartilage.  The bone is actually part of the nasal spine.  This can all be done through a close rhinoplasty technique with dissolvable stitches and will not cause flaring of the nostrils.  Excess flaring of the nostrils is usually caused by dorsal hump reduction, which decreases the overall projection of the nose.  An alarplasty can be performed if flaring does results.

You have posted before and I believe you are over thinking this and will be frustrated in trying to understand the answers to technical questions because you don't have the context to place them in. I recommend you have a consult with computer imaging to show you what different changes would look like on your nose (de rotation, nasal spine shortening, lengthening etc). Once you visualize what you like, and you agree on it with your surgeon let him/her decide what technical steps are needed to get you to that result. It won't help you much to hear that "bone will be removed" or "cartilage added and sutured" etc.

The area of concern you point to in your photo is the region of the anterior nasal spine.  Although a portion of that bone can be taken down slightly, there is another issue that relates to the shape of the skin envelope and how it would redrape into a more concave shape.  This is a little less predictable.  You appear to have an overprojecting nasal tip.  Decreasing the length of projection will involve excising a portion of the anterior nasal spine as mentioned and a portion of your caudal septum.  You may or may not need to combine this with some tip work to help soften the overall appearance.  Photos from the front and worm's eye views would help understand the anatomy of your problem better.

I have performed Rhinoplasty for over 20 years and from the profile photo the nose has a hanging Columella with an over-projected nasal tip and dorsal hump.  A Closed Rhinoplasty would be required to perform: 


Dorsal reduction

Decreased nasal tip Projection

Columellar tuck without emoving that abterios nasal spine (bone)


Hope this helps.

That "curve" is bone and/or cartilage. I agree that a portion of this fullness should be removed. The cartilage is removed with scissors or a knife; the bone is removed with bone biting scissors, a rasp, or an osteotome that breaks the bone before removal.