Potruding nasal spine causing tethered lip, makes nose & lip not 'flow'.Can I fix this w/o doing a complete rhinoplasty?(photos)

Wow, you've researched this issue impressively.  I don't see a profile view or a picture that shows relationship between lips and teeth.  Those factors are important (in addition to physical exam) to understand your situation and in deciding how to manage.Because the nasal spine, base of columella, and upper lip are together in a small exposed area, such problems CAN be fixed under local anesthesia.  Still, because operating on one area affects relationships of that area with adjacent structures, adjustments to those adjacent structures (nasal septum, nasal tip, upper lip) are often required for natural harmony and proportion.  If this is the case, general anesthesia and a more comprehensive procedure may be recommended.

Protruding nasal spine and tethered lip? You also have a slightly projected tip which may need to be reduced to give you what you want. I need to see better photos or an examination to determine if reducing only the spine would be sufficient. See an experienced rhinoplasty surgeon to discuss these issues and so you do not end up with an overdone nose .

A nasal spine almost never, by itself, causes a tethered upper lip. It's almost always the tip cartilages that cause it, because the tip cartilages make the nose tip protrude strongly forward, away from the the face, and it's that forward protrusion of the tip that causes the tethering, like in the woman in the short attached video.I'll bet, if you send or post some profile views, we'll see that it's the tip protrusion that's causing the issue.If anyone grabs her nasal tip, and pulls it out farther forward away from the face, it'll cause the upper lip to tether.Also, you must be very observant, because it's almost always that the tethering is noticed in the *profile* view, not in the frontal views, as you have posted and commented on. You should understand that the changes required to reduce upper lip tethering require advanced techniques, techniques that most plastic surgeons cannot handle. Be sure to read the section in the "Web reference" link, just below my response, on how to stay out of trouble while searching for a rhinoplasty surgeon.Your nose is also a perfect example of why computer imaging is mandatory in rhinoplasty. You need to know exactly what the surgeon is planning to accomplish, so you know whether it's enough to be meaningful to you, and whether he understands your wishes enough to address all of your priorities. Then, he must show you before and after photos to prove that he can accomplish what he draws on the computer.

It is difficult to judge by photos alone whether or not you are a candidate for nasal spine surgery. Any manipulation of the nose can affect your breathing as well as the appearance. You should consult with a board certified plastic surgeon who can help you determine the right course of treatment for you.

Whether the tethered lip is caused by a long anterior nasal spine, a long caudal septum or both, either one or both can be treated without a rhinoplasty procedure.

The upper lip can seem tethered and tense for a number of reasons. One of the reasons is the relationship to the nose. A protruding nose can create tension on the upper lip. To be sure, it is best to have a consultation with a rhinoplasty surgeon. I would ask you some specific questions, exam your lip, inside your mouth and your nose. Most importantly, I would take photographs from all angles as well as photos while you are smiling and other movements. Lastly, we would look at a 3D simulation together to make sure we are on the same page and talking about the exact issue you would like to address.It sounds like a lot, but all that information is needed to make the correct diagnosis and create treatments options that are appropriate and safe for you.

Without a true side view it is impossible to say whether your request is reasonable. Based on the front view I do not think it is. Removing the spine will decrease the nose-lip angle, retrude the columella and rotate the tip downward. From a front view that does not look like a good idea.

A full set of facial photographs especially of the side profile are required to make a determination along with an in-person examination to determine what can and cannot be accomplished with a rhinoplasty procedure. When patient's have a hanging columella, the nasal spine and the caudal septum can both be trimmed back. This includes removal of cartilage, bone and skin on the inside of the nostrils. We do not recommend this procedure under local anesthesia due to the extensive amount of nerve endings that are in that location, because it will be a very painful to undergo the procedure  to get that area numb. For many examples of reduction of a hanging columella with and without and adjusting the nasal spine, please see the link and the video below

Hello ekelly, thank you for your question. It is difficult to assess your nose with the provided images. You may consider providing profile images as well to assist with the assessment of your nose. I would recommend an in-person consultation regarding your nose to assess what the best method of correction may be. Often "tension noses" are not usually only caused by the nasal spine so other maneuvers would likely be necessary. I routinely perform rhinoplasties under IV sedation (not general anesthesia).

Thank you for the question and the simple answer is YES the spine can be shaved under local without a formal rhinoplasty.  So see some experts in your area and find the right surgeon for you.Dr. Corbin