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

I don't have a tethered lip but when i feel my columella i don't feel any cushion/space just a hard bone directly underneath touching the flesh, is this normal? could this be used to my advantage when shortening the nose?

Doctor Answers 10

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

 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.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Having a Large Nasal Spine Is a Non-issue

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. 

Michael R. Menachof, MD
Greenwood Village Facial Plastic Surgeon
4.4 out of 5 stars 26 reviews

Nasal spine

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


Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

Septum Not Spine Is What You Are Likely Feeling Behind Your Columella.

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.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Large Nasal Spine Signs

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.

Alberto Di Giuseppe, MBBS
London Plastic Surgeon
3.5 out of 5 stars 25 reviews

Prominent nasal spine

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. For examples similar to this problem, please see the  link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 146 reviews

Large Nasal Spine

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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

The large nasal spine

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.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Large Nasal Spine

  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

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 496 reviews

Benefits of reducing the nasal spine

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.

Thomas Buonassisi, MD
Vancouver Facial Plastic Surgeon
4.9 out of 5 stars 108 reviews

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.