TRIANGULAR NOSE SKIN

This notching corresponds to the soft tissue triangle of the lobule. One of the hallmark features of the domal segment that affect appearance of the nasal tip and nostril shape is notching of the cartilage at its caudal aspect. The lobular segments can be extremely varied, and this corresponds to much of the extensive variation and diversity in tip shape. The middle crus begins at the columellar and lobular juncture and ends at the lateral crus.'' Its two components are the lobule and domal segments. The columellar segment is ideally oriented vertically and is primarily responsible for nostril length and nasal tip projection. Angulation of the foot-plate segment occurs in a medial to lateral and anterior to posterior direction. The medial crus is divided into the footplate and columellar segments. Each of these portions is composed of two segments. Each LLC is composed of three crura: the medial, middle, and lateral (Fig. The lower lateral cartilages (LLCs) are critical in defining the nasal tip and nostril shape.

Variations or changes in any of these structural components or their relation-ships to one another may alter the appearance and attractiveness of the nostril shape, and ultimately, affect nasal function.

TRIANGULAR NOSE SKIN

In evaluating the nostril shape from the base view it becomes apparent that contributions from the lower lateral cartilages, the anterior nasal spine, the caudal septum, the maxilla, the upper lip, and the skin and soft tissue envelope of the nose all contribute to the overall appearance. Finally, a systematic approach of surgical techniques to alter the nostril shape is provided. Modifications of this technique were reported by Joseph.' In 1943, Aufricht, using the methods of Weir and Joseph, described a modified technique in alar reduction that remains popular today.' The authors present a discussion on anatomic aspects of the nasal base, strategies to analyze the nasal tip and nostril shape from the base view, and variations in nostril shape. The first descriptions of nasal base reductions to alter the nostril shape were described more than a century ago by Weir. The nasal base and nostril shape are important characteristics to consider during the planning and execution of aesthetic and reconstructive rhinoplasties.

Triangular nose