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Anterior nasal spine (ANS) recontouring/subspinal osteotomy: Reduction of the ANS can be undertaken when advancing the maxilla in order to control nasal tip rotation, as advancement of the maxilla often leads to nasal tip upturning.
Anterior boundary: line connecting the anterior nasal spine (ANS) and the apex of the nasal bone; posterior boundary: line extending from sella (S) to posterior nasal spine (PNS); superior boundary: line connecting basion or the highest point on the nasal bone 1 mm inferior to the edge of the field of view and S; and inferior boundary: line extending from ANS to PNS.
A specially marked (in mm) stainless steel rod (2 mm diameter), was used to measure the site of the opening from the anterior nasal spine (this is the fixed bony point nearest to the opening, taken as the reference point).
Inferiorly, the segment is separated completely from its attachment to the anterior nasal spine and maxilla.
For analysis of the piriform aperture morphology, the following forms were considered: pear, inverted heart below anterior nasal spine, rhomboid, inverted heart at the anterior nasal spine, oval, trapezoidal and rounded (Fig.

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