A Nasal Columellar Base Stabilizing Suture Technique

Summary: When seeking to achieve a more aesthetic and narrower columella, most of the required changes concern the middle and base of the columella. Narrowing and reshaping the columellar base require a sequential approach with a good anatomical knowledge and aesthetics analysis. The columellar base is a three-dimensional structure that must be analyzed following 3 axes: transverse (thickness or width), frontal (height), sagittal (nasolabial angle). Frequently, sutures that aim to close the distance between the medial crura footplates result in modifying the nasolabial angle, as a side effect, due to caudal protrusion of the columellar soft tissue. The question is: how to keep an adequate nasolabial angle? A transverse columellar base stabilizing suture acting on these 3 axes, that enables to maintain the result after the columellar base management, is described in this article.