Classification and correction of alar-columellar discrepancies in rhinoplasty

A classification of alar-columellar discrepancies is described based on a new definition of the ideal alar-columellar relationship. On lateral view of the ideal nose, the nostril is oval, with the alar rim forming the superior nostril border and the columella forming the inferior border. The distance from the long axis of the nostril to each of these borders should be 1 to 2 mm. A columella-to-nostril-axis distance of less than 1 mm or more than 2 mm indicates a retracted or hanging columella, respectively. Conversely, an ala- to-nostril-axis distance of less than 1 mm or more than 2 mm corresponds to a hanging or retracted ala, respectively. Treatment options for each type of alar-columellar discrepancy are discussed. This classification enables greater accuracy and precision in the analysis and correction of alar- columellar discrepancies.