Surgical elongation of the short columella is a challenging problem for the
surgeon. Although some flaps from the upper lip are successfully used to c
orrect this deformity on cleft lip patients with a scarred upper lip, these
methods cannot be applied to noncleft patients with a smooth upper lip. Di
stant flaps and composite grafts do not give the best aesthetic results. Th
e use of an external approach for rhinoplasty is preferred by many surgeons
, especially for difficult or secondary cases. Most incisions for open rhin
oplasty are placed on the columella. This report describes a new incision f
or open rhinoplasty to be used on patients with a short columella. The inci
sion is a standard forked flap with a columellar base but the legs of the f
lap extend to the nostril bases instead of to the upper lip. This method wa
s used on eight aesthetic rhinoplasty patients with a short columella betwe
en March 1995 and March 1998. The results of the method are discussed.