Obtaining a gentle contour to the columella by modifying the maxillary spine

There are several structures involved in columellaplasty, and all affect the support and shape of the tip, the columella, and the upper lip. The present paper considers only the problem of the deformities of the maxillary spine and its lower extension over the midline, causing broadening and asymmetrical development of the columella as well as a short upper lip, and an obtuse columella-lip angle. During rhinoplasty, the nasal spine can be exposed and reshaped by carving and remodeling with drilling. At the same time, the support this structure provides for the columella and tip can be retained. This paper is based on follow-up of 50 patients on whom surgical correction of the maxillary spine was performed with satisfactory results in 90 percent.