Columella: the bridge between the nasal tip and the lip

The columella is the small strip between the two nostrils that connects the tip of the nose to the upper lip. Its base is formed by skin over the medial crura of the nasal cartilages and by the anterior portion of the nasal septum. Seen from the side, it is one of the structures that define the outline of the nose.

What is assessed?

In the profile assessment, you look at the columellar show: how much of it appears below the edge of the nostril rims. There is a range considered typical, but it varies between people and groups. Too much or too little show changes the relationship between the nasal tip and the lip.

Another measure is the nasolabial angle, formed between the columella and the upper lip, at the level of the subnasale. It describes the rotation of the tip, which has the greatest effect on the profile.

Why does it need care in HOF?

Nonsurgical rhinoplasty with filler works on the tip and columella area. It is a high-risk area: the columellar artery supplies the skin of this strip and connects with vessels that feed the nose. Vascular occlusion there can cause skin necrosis, and nonsurgical rhinoplasty requires training, experience and hyaluronidase on hand.

How do you talk to the patient?

Patients mention a "drooping tip" or a "big nose." Show, on a profile photo, where the columella is and how it relates to the tip and the lip, to align expectations about what a nonsurgical procedure can and cannot change.

In Harmy

Harmy has no point for the nose and uses only the front photo. The columella and nonsurgical rhinoplasty are outside what the app simulates.