It starts from above the incisal fossa of the maxilla, adjacent to the muscle fibers of the base of the nasal muscle, and attaches to the medial pedicle of the inferior lateral cartilage and the membranous nasal septum, with a few muscle fibers moving anteriorly along the two medial pedicles of the inferior lateral cartilage and distributed in the dome of the inferior lateral cartilage. A few muscle fibers from the anterior nasal crest of the maxilla and the orbicularis oris muscle are also involved in the formation of this muscle bundle. This is inconsistent with Rohrich et al. who suggested that the majority of the descending nasal septum originates from the fusion of the medial pedicle and the orbicularis oris muscle here, and with the results of the three-class typing study of this muscle. It is the same argument as Daniel et al. who suggested that the origin of the descending nasal septum muscle from the orbicularis oris is a misconception caused by an extraoral top-down anatomical approach. Contraction of the descending septal muscle causes the septum to descend, widening the nostril and shifting the tip of the nose downward. Making a smiling expression, with the synergistic action of the orbicularis oris muscle, carries the descending septal muscle down to pull the tip of the nose and also changes the direction of ventilation. In addition, it is important for aesthetics because when it contracts, it narrows the nasal columella-superior lip angle, so this muscle should be treated appropriately during long nasal shortening surgery, otherwise it will cause recurrence of long nasal deformity. Releasing the tension of this muscle not only reduces the pulling down force of the nasal tip, but also causes a slight drooping of the upper lip. We need to be familiar with this characteristic and inform the patient preoperatively about the choice between surgery to improve the degree of the “gummy smile” and the possible drooping of the upper lip.