Importance of the columellar-labial junction in rhinoplasty

Concentration on tip positioning may draw a surgeon's attention away from modifying positions of the nasofrontal angle and of the columellar-labial junction. All three landmarks are, however, vital to the establishment of desirable profiles. This article emphasizes that changes in the positioning of the columellar-labial junction may (1) eliminate certain hazards involved in changing tip position, (2) make it possible to produce aesthetic effects that cannot be achieved with tip positioning alone, and (3) make rhinoplasty safer and more predictable in certain difficult cases. Also presented are techniques that have been found to work most satisfactorily in changing angle and position. A few patients selected from among several thousand rhinoplastic cases are analyzed to underscore the significance of this area in rhinoplastic planning. Follow-up varied from several months to several years.