Reshaping of the Anterior Nasal Spine: An Important Step in Rhinoplasty

Overview

The anterior nasal spine is the small bony projection at the base of the nose where the septum anchors. The authors argue it is often overlooked in planning and that its size or position can be abnormal. This study reviews their surgical treatment of that structure, done alone or with other reshaping techniques.

Sections of note

• 160 patients underwent surgical treatment of the anterior nasal spine, with or without other nasal reshaping.
• Spine abnormality types: 87 with hyperplasia, 43 with hypoplasia, 30 with deviation.
• 15 cases had a combination of deviation and hyperplasia.
• No patients developed postoperative complications.
• 5 patients who had spine reduction reported numbness in the premaxillary area; sensitivity fully returned within 4 months in all of them.
• All patients reported postoperative improvement of nasal airflow.
• Aesthetic result was rated excellent by 142 patients and good by 18.
• The abstract states no follow-up length beyond the 4-month numbness figure, and no comparison group.

What it means for a patient

• A small bone at the base of the nose influences the angle between the nose and the lip and can be too large, too small, or off center.
• Adjusting it is described as simple, and in this series produced no complications.
• Temporary numbness above the front teeth occurred in 5 of 160 after reduction and resolved within 4 months.
• Limits: no comparison group, self-reported airflow rather than measured, no stated overall follow-up length, and the satisfaction ratings come from within the treating practice.

Why this paper matters

Nasal analysis usually concentrates on the hump, the tip, and the septum, and this paper argues a small bony landmark deserves routine attention. The reported results are uniformly positive. Without objective airflow measurement or a control group, how much of the benefit came from spine work rather than the other techniques used alongside it is unclear.

Terms

• Anterior nasal spine: The small bony projection at the base of the nose where the septum anchors.
• Hyperplasia: Overgrowth, meaning the structure is larger than normal.
• Hypoplasia: Underdevelopment, meaning the structure is smaller than normal.
• Nasal pyramid: The overall bone and cartilage framework of the nose.
• Premaxilla: The front part of the upper jaw, just behind the upper lip.