Columellar Aesthetics in Open Rhinoplasty.

Detailed descriptions of the ideals of columellar aesthetics and nostril shape are conspicuously lacking from the medical literature. Achieving an aesthetic nasal base is critical to an optimal rhinoplasty result. Deviations in the columella and variations in its width and height lead to distortion of nostril shape and frequently compromise function. Six types of columellar disproportion are presented with detailed explanations of how to treat each. By properly recognizing and addressing columellar deformities, the surgeon can optimize both the aesthetic and functional results that are achieved.