Over Projecting Nasal Tip

Over projection of the nasal tip occurs when nasal tip projection exceeds 0.67 X ideal nasal length (see analysis). Obviously, determining ideal tip projection is more than simply scrutinizing the nasal profile. It involves careful facial analysis through which ideal nasal length is calculated. When existing tip projection exceeds the ideal, an over-projecting tip is present. The consequence of lowering tip projection has a three dimensional effect. The nasal length, width of the the tip, and nasal base may also change. Accordingly, reductions in projection exceeding 3-4 mm must be carefully contemplated. The other dimensional changes may be less desirable than the benefit of further decrease in projection.

	As nasal tip projection is decreased there is outward bowing or widening of the nostrils. This sometimes necessitates a partial resection of the nostril base to bring it back into proportion. Notice also that as tip projection and dorsal (bridge) height is decreased, the nose appears longer.

I generally use an open rhinoplasty approach when decreasing nasal tip projection so as to securely stabilize the mobilized tip structures. Sutures and support grafts may be needed.