One of the potential complaints of rhinoplasty patients is that their nose is too long. This should be differentiated from someone who feels that their nose is too big. While big may mean long when it comes to the nose, most of the time patients use the term big in reference to the size of the nasal tip or to a nose with a large hump and plunging tip that is also too long.
From a rhinoplasty standpoint, the length of the nose refers to a measurement from the top of the bridge down to the most forward point of the nasal tip. There are some anthropometric assessments as to what the most pleasing nasal length should be the classic one being that the nasal length should only be as long as the height of one’s ear. There are also some specific measurements and proportionate relationships that also define ideal nasal length but suffice it to say if you think it is too long ¦it is probably too long. The most common feeling is that the length of the nose does not appear to be in proportion with the rest of your face.
The most common cause of a long nose is that the septum is overgrown, driving the tip cartilages forward and often down as well. In my Indianapolis plastic surgery practice, I approach this nasal problem through an open rhinoplasty. This enables one under direct vision to remove the end of the septum and reposition the tip cartilages up and back. In some cases, both of these maneuvers are needed. In others, only tip repositioning is needed. Precision and accurate placement of sutures are needed to get a satisfactory result.
The application of tapes are placed at the end of the rhinoplasty which helps control swelling and support the nasal tip in its new position. The use of tapes may give the appearance that the nose is too short or uplifted too much. This is a temporary distortion caused by the tapes which passes when the tapes are removed a week or so later.
The biggest concern with long nose correction is that the nose may appear too short or uplifted after. This is avoided by not removing too much septum or overlifting the tip cartilages by sutures that are too tight.
Dr. Barry Eppley
Indianapolis, Indiana