The nasal base is very complex secondary to the dynamic relationship between the skin, underlying muscle, and cartilaginous structures. Recently, we have employed a new method for refinement of the nasal base, which we name reduction columelloplasty. This procedure employs a full-thickness diamond-shaped tissue excision between the feet of the medial crura. The incision is carried down through the skin, depressor septi muscle, and adjacent soft tissue. Following en bloc removal, the defect is carefully closed in a vertical orientation, approximating the medial crura of the lower lateral cartilages. As in the open rhinoplasty approach, the scar produced by this technique is of negligible importance if it is closed using proper techniques of skin eversion and early suture removal. We have found this procedure to be an extremely reliable method for narrowing splayed medial crura, increasing the nasolabial angle, modifying the shape of the nares, and for increasing tip projection.