Rhinoplasty for the Short Nose

Dallas Cosmetic Surgeon, Dr. Steve Byrd, has lectrued and written extensively on the correction of the short nasal deformity in rhinoplasty.

A short nose is present when nasal length is less than 2/3 mid facial height. Nasal length should be exactly equal to the stomion to menton distance (see analysis). It is also defined by a nasolabial angle greater than 105-110 degrees.

Causes of a short nose nasal deformity may be either congenital or traumatic. Congenital causes result in a failure of the nose to grow proportionately to the face. Traumatic shortening involves collapse of structure and scar contracture of nasal lining. The same consequence can be seen in rhinoplasty where too much supporting structure or lining is removed. Physical trauma in children is particularly problematic in that there is not only injury to existing structure but the possibility of interruption of subsequent normal growth in the nose.

Lengthening a nose that is short is one of the most difficult tasks in rhinoplasty. When of congenital origin, correction generally involves the introduction of skeletal structure and mobilization of nasal lining. When of traumatic origin, correction not only involves replacement of structure but also release and often supplementation of lining or skin. The source of tissue for replacing structure frequently involves grafts of cartialge taken from the nasal septum, the ear, and the rib. My choice for controlling the length and projection of the nasal bridge as well as projection and definition of the nasal tip is most often rib cartilage. Septal and ear cartilage are used to gain additional definition and shaping in the nose.

The red in the diagram represents a release and downward and outward movement of the nose secured by rib grafts.