Diagnosis and surgical management of the caudal excess nasal deformity

Surgical correction of the overgrown columella-labial junction remains a controversial and neglected aspect of cosmetic rhinoplasty. Failure to reduce an obtuse nasolabial angle resulting from overgrowth of the septum and/or nasal spine may adversely affect the otherwise satisfactory cosmetic result. I review the historical considerations regarding caudal overgrowth and discuss its relevance to contemporary rhinoplasty. Case studies are presented to illustrate surgical treatment options for various overgrowth deformities.