Large nasal spine/caudal septum cartilage? What can be done? (photos)

Okay so my whole life I've deal with my terrible nose... based off what I've read I've concluded that it is due to an overgrown nasal spine/ excess septum cartilage. So my question is what can be done to correct the angle between my lip and my nose? If the excess bone and cartilage is removed will the skin move up into place or will it still hang and what is the name for the deformity?? Thanks in advance.

Doctor Answers 8

Large nasal spine?

Hi Troy, From your fotos i think the problem may actually be that the bridge of your nose is too high and this pulls your lip up and gives the appearance that the nasal spine is too big. At a consultation your exam will help to determine the exact cause and its correction. caution needs to be taken when resecting part of the nasal spine to avoid making the angle too deep.


Detroit Plastic Surgeon
4.5 out of 5 stars 31 reviews

Large Nasal Spine/LongCaudal Septum

The large nasal spine and/or long septum can be removed to improve your naso-labial angle. The skin will contract and adapt to the new contour.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Rhinoplasty for large nasal spine and caudal septum

A rhinoplasty procedure can address shaving down the nasal spine and trimming back the caudal septum. This is also known as a columella-plasty for a hanging columella. This is usually performed at the same time as the rhinoplasty procedure. For many before and after examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 129 reviews

Anterior nasal spine

It certainly looks like your anterior nasal spin and septum are contributing to the issue you are concerned about. A small resection of this are should resolve your issue.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Nasal surgery question

 Thank you, these are all good questions. Looking at your pictures, it appears that you have possibly some excess septal cartilage. In these situations we usually trim off some of the cartilage so that the area of the upper lip does not look as full.   This technique is performed as part of the septorhinoplasty procedure. We commonly performed these procedures to improve breathing as well as appearance of the nose. If you would like improvement in the appearance of the profile as well as the tip of the nose, this can also be performed.Only an in person consultation will let us determine and perform an internal and external nasal exam.  Regarding the skin, it usually contracts to the new shape of the nose after the rhinoplasty. This is part of the recovery phase, and may take six months to one year to fully evolve. Trust a surgeon who has performed rhinoplasties, and can discuss these issues with you. Good luck! 

Kailash Narasimhan, MD
Sherman Plastic Surgeon
5.0 out of 5 stars 14 reviews

Nasal Spine

You have done a good job of learning the basics of the issue. Skin does not hang afterwards. The tissue are tight enough that redraping is not an issue. I suspect you can find (if you haven't already) plenty of before and after photos on-line that show typical results from similar patients.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.4 out of 5 stars 71 reviews

Terrible nose?

Well I have to say first... I like your nose. Yes, I'd recommend making a smaller version- lowering the dorsum and removing some of the cartilage underneath, but your nose is basically pretty good. I'd say to you... don't let anybody change it too much! Good luck.

Scott W. Harris, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 30 reviews

Rhinoplasty for large nasal spine and cuadal septum

You diagnosis appears to be accurate.  During rhinoplasty this excess tissue can be reduced by removing some of the bone of the nasal spine and some of the cartilage of the caudal septum.  The tissues ends up relaxing into the void and makes the fullness in that better, not perfect, but better.  It this works even better if the entire nose is deprojected some.  Most noses need this maneuver anyhow.  I think you would be happy ultimately with what you can achieve.  I am in Austin, not too far away.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
4.9 out of 5 stars 51 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.