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Over ProjectedDoes your nose seem too big for your face?

When people think their noses are too big there are three possible dimensions or measurements that can be excessive: The length (the distance from where the nose starts below the forehead to the nasal tip), the width (as viewed from the front), and the PROJECTION (the distance the nose sticks out into space). Some large noses are large in one dimension and some in all three. The nose that is not too long and not too wide but just sticks out too much is sometimes called the Pinocchio nose.  Obviously, the length and projection are most easily judged on the side profile whereas the width is best judged from the front.

There are other reasons a nose might look over-projected such as a small chin but that is another subject.

How to know if you have an over-projected nose?

There are several ways a rhinoplasty surgeon judges the projection of the nose. One method is to compare the nasal length with the nasal projection. The nose should ideally project to a distance about 2/3 the length of the nose. The problem is that some patients want both the length and the projection modified, making a judgment of projection more difficult. Another method is to draw a vertical line touching the most projecting part of the lips. Ideally no more than about 60% of the nose should project in front of that line. These measurements are not the only considerations but help the surgeon evaluate the extent to which the patient’s perception of a large nose is due to the projection and to what extent the nose might be large in other ways.

How do you fix an over-projected nasal tip?

To reduce the projection of your nasal tip requires that you undergo a rhinoplasty procedure.

Dr. Thorne employs one or more de-projection techniques to reduce the distance your nose sticks out into space. This procedure is usually performed through open rhinoplasty but it can be accomplished through an endonasal or closed approach.

Techniques used include:

  • Extensive dissection.

For noses that are minimally over-projecting, the dissection of the nasal tip alone will release some of the attachments to the skin and allow the cartilages in the tip to sit back a few millimeters.

  • Division of the lateral crura of the tip cartilages

The two cartilages in the nasal tip have a component on each side that extends from the nasal tip toward the side of the nose.  If these lateral crura, as they are called, are divided, the nose will sit back closer to the face.

  • Division of the medial crura.

The two cartilages in the nasal tip also have a component on each side that runs up the columella – the divider between the two nostrils. Division of the medial crura, as these are called, will also cause the nose to stick out less and to sit back closer to the face.

One of the challenges of rhinoplasty surgery is that changing one thing can result in changing another thing. For example, taking down a hump on the bride of the nose makes the nose look longer. That is why you should seek advice from an experienced rhinoplasty surgeon. Frequently multiple variables will be altered in one operation. For example, the surgeon might shorten the nose by rotating the tip upwards AND de-project the tip so it is not sticking out so far.

If you would like to have your over-projected nose fixed, schedule an appointment with Dr. Thorne. He is an expert rhinoplasty surgeon in New York and has been performing, writing, and teaching nose surgery for more than three decades. He will explain to you the necessary steps of the procedure and discuss any concerns that you might have. 

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