The nasal tip: a new dynamic structure.

In my study of patients consulting for facial profile imperfections, I have found a pathology that is related neither to the osseous nor to the cartilaginous structure, since it is an individual entity corresponding to a defined muscular activity. I detected and described the morphology of a digastric muscle (m. digastricus nasi-septi labialis) that links the nose to the upper lip with a columellar portion originating in the nasal tip and a labial portion, both joined in the center by an intermediate tendon functioning as a pulley, which is inserted in the anterior nasal spine. These muscular portions may function either independently or synchronously. The imperfection will appear according to the predominance of one or the other, or both, and the contracture of the two muscular portions. In this paper a didactic classification is established as septum 0, I, II, or III according to the levels of seriousness.