Rhinoplasty can make the facial features more coordinated and beautiful and improve the three-dimensional sense of the face, however, when people are concerned about rhinoplasty, it is easy to ignore the interrelationship between the nasal wing – nasal small column, thus appearing after plastic surgery still feel that the nose shape is not ideal, below I will briefly introduce the importance of the nasal wing – nasal small column relationship. Nasal wing – nasal column relationship Frontal view, ideally the nasal wing – nasal column can be reflected by the line drawn along the nasal margin at the connection of the small column – lobular angle, this curve is similar to the gently flying sea o wing; the vertical distance between the nasal column lobular angle and the nasal tip performance point should be evenly divided by the horizontal line passing through or adjacent to the highest point of the nasal wing margin. Otherwise, there is a nasal wing – nasal collet defect. In the lateral view, it is generally considered that the nasal columella revealing 2~3mm is beautiful, the shape of the nostril should be oval, the nasal flange forms the upper part of the oval, and the lower part is formed by the connection of the nasal columella skin and the nasal vestibule skin. The straight line drawn through the foremost and last points of the oval is its long axis and divides it into two parts, upper and lower. In a normal nasal wing-nasal column relationship, the maximum distance from the long axis of the nostril to the nasal wing margin or nasal column margin should be 1~2mm, or AB=1~2mm, and BC=1~2mm. Classification and treatment Using the distance from the long axis up to the nasal wing margin (AB) and the distance down to the nasal column margin (BC), we can classify the nasal wing-nasal column relationship into six categories. Classes I to III are associated with increased nasal minors exposure, while classes IV to VI are associated with decreased nasal minors exposure. Class I is a true nasal column overhang, in which the distance between the long axis of the nostril and the nasal column margin is greater than 2 mm and the distance from the long axis to the superior nostril margin is 1 to 2 mm. correction of nasal column overhang includes membranous septal excision and realignment, with or without excision of the caudal edge of the nasal septum (light red area). If the medial pedicle is too wide and involved in constituting the amount of nasal column exposure, it is the excision of its caudal edge and the overlying nasal vestibular skin and realignment of the skin edge (light red area) to reset the nasal column edge. Type II is a nasal recession characterized by a distance of more than 2 mm from the nasal margin to the long axis of the nose and a distance of 1 to 2 mm from the nasal column margin to the long axis. In this case, the doctor must be careful to differentiate and not misdiagnose nasal recession as nasal column overhang. Treatment is significantly different for different diagnoses. Measures to correct nasal recession focus on lowering the nasal margin by using composite tissue grafts or cartilage grafts. With composite tissue grafting, the skin of the nasal vestibule is incised parallel to and above the nasal flange. The nasal vestibular skin is freed to retract caudally, which lowers the nasal margin. The septal or auricular cartilage composite graft is trimmed into a pike shape and sutured to the surgically created defect area. The composite graft should usually be slightly larger than needed to counteract the unpredictable secondary contracture after grafting. When the nose is mildly receding and there is no tissue deficiency, the lateral pedicle can be detached from the accessory cartilage and transposed downward. This allows the nasal edge to be grafted downward. Type III is a mixture of Type I and Type II. This mixed deformity manifests as nasal column overhang and nasal wing recession and needs to be addressed separately using the various operations described above. Class IV is nasal overhang. Nasal overhang results in a shortening of the distance from the nasal margin to the long axis of the nostril, which results in a reduction in the exposure of the nasal column. There are many treatment options, including direct nasal excision. In individuals with thin skin, the nasal margin can be elevated by carefully trimming the caudal edge of the lateral pedicle without removing the mucosa. A horizontal oval excision of the nasal vestibular skin no more than 3 mm wide can raise the nasal margin by 2 mm without producing distortion of the nasal margin. The width of the excision should be slightly more than the amount of correction needed but not more than 3 mm. if too much skin is excised, it may cause the nasal margin to curl inward toward the nostril. Type V is a receding nasal column characterized by a shortening of the distance between the nasal column and the nostril axis. A sculpted cartilage support graft is placed into the cavity between the medial pedicles, and the caudal edge of the graft is extended below the caudal edge of the medial pedicle to push down the nasal column. The widest portion of the supporting graft should be placed at the site of greatest retraction, which will return the nasal wing-nasal column to normal. If necessary, the supporting graft can also be used to adjust the minicolumn-superior lip angle. Class VI is a mixture of Class IV and V. This rare deformity can be resolved by the combined application of the above described types of deformity opening treatment.