What Are the Signs of a Large Nasal Spine and What Can Be Done About It?

  If the caudal septum is prominent and creates a less than favorable nasolabial angle, the caudal septum and the spine can be reduced.  Find the plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties each year.  Kenneth Hughes, MD Los Angeles, CA

The nasal spine lies below the skin at the junction of the nose and the lip. How it feels to touch is not as important as how it looks. If it is prominant it can blunt the nasolabial angle and this may not be ideal for your facial features. In my practice I modify the nasal spine to sharpen the nasolabial angle when needed but it has no bearing on the overall length.

This is one of the difficulties with the internet and why RealSelf is so helpful. You are obviously intelligent and have researched the issue, but don't have the educational filter to figure out some of the nuances of the issue. That's what we're here for. Yes what you are feeling is normal. It might be your nasal spine and it might be the septal cartilage. Either way it doesn't make any difference which of the two it is because it has no bearing on how easy or difficult it would be to shorten your nose. A good rhinoplasty surgeon has to deal with one, the other or both when doing a rhinoplasty. One is not more difficult to deal with than the other. If you're really interested in considering a rhinoplasty, see a local surgeon for a consult. Good luck. 

By your description, most likely what you are feeling is the caudal end of the septum not the anterior nasal spine. Adjusting septal length can play a key role in efforts to shorten the nose in rhinoplasty.

The anterior nasal spine provides the support for the septum. Resection of the anterior nasal spine does not affect he size of the nose, it only affects the length of the nose. With regards to a tethered lip, partial resection of the nasal spin and most of the depressor septi muscle can produce a better projected lip.

A  prominent nasal spine  is composed of the bone of the maxilla which supports the floor of the nose.  In some patients, its quite large and  can tether  the upper lip. A prominent and hanging columella can also be present in addition to a large nasal spine. Conservative cartilage trimming along with skin membranes on this area  can reduce the signs of prominence of the nasal spine and tuck in the columella. Trimming back a prominent spine and columella will also shorten the nose in the vertical dimension.  All this can be performed with the closed rhinoplasty approach with all incisions placed on the inside of the nose itself. For examples similar to this problem, please see the  link below

The anterior nasal spine is a prominent point at the botton of the columella. When it is large, the angle between the lip and nasal tip can be open and give the appearance of a short upper lip. When needed the spine can be reduced, to close the angle and improve the lip length and balance.

 A large nasal spine would cause the inferior, or lower, portion of the columella to protrude. This is called columellar show.  The treatment is a local resection, or removal, of the anterior septal angle as well as a portion of the bony anterior nasal spine.  This is an isolated procedure that does not require a complete Rhinoplasty.

You may be feeling the nasal spine when you touch your columella.  The question is; what do you want to change about your nose?  The nasal spine will be treated as part of your columellar structures in the rhinoplasty strategy and planning.

Talmage Raine MD FACS

drraine.com

The hard structure you're feeling is either the nasal spine or the end of the septum. These prominent structures can be reduced as part of a rhinoplasty but do not impact the surgeon's ability to shorten your nose.