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Over Projected Nose

Dr Jason Roth (MED0001185485) — Specialist Otolaryngologist & Head and Neck Surgeon, specialist registration in Otorhinolaryngology, Head & Neck Surgery.

All cosmetic surgery involves risks and individual results vary. Cosmetic surgery is a serious decision. Decisions about whether to proceed should be made after careful consideration and following at least two consultations with a qualified medical practitioner.

Nasal tip projection refers to how far the nasal tip extends forward from the face. When the tip projects further than is proportionate to the rest of the nose and face, patients may seek rhinoplasty to address this. The assessment and surgical planning of tip projection is among the more complex aspects of rhinoplasty.

All surgery carries risks — read the full rhinoplasty risks page →


What Causes Increased Tip Projection?

The most common causes of an over-projected nasal tip are overgrowth of the lower lateral (tip) cartilages, an overly long or prominent caudal (front portion of the) nasal septum that pushes the tip cartilages forward, or a combination of both. It can be a primary feature of the nose present from early development, or can occasionally result from previous rhinoplasty where tip support structures were over-built.


Surgical Approach

Reducing tip projection requires careful planning — the tip does not exist in isolation and changes to it have knock-on effects on the dorsal profile, the nasolabial angle, and the overall proportions of the nose. The surgical approach typically involves one or more of the following:

Tip cartilage modification
The medial crura of the lower lateral cartilages can be shortened or repositioned downward using sutures to reduce the forward extent of the nasal tip. This requires careful technique to avoid destabilising the tip support structures.

Caudal septal reduction
Where an overly long caudal septum is contributing to tip projection, controlled reduction of the caudal septum allows the tip to settle back to a less projected position.

Dorsal adjustment
When the tip is reduced in projection, a relative dorsal prominence may develop — or become more apparent — as the tip recedes. Careful assessment of the dorsal profile before and during surgery is essential to ensure the overall nasal proportions remain balanced after tip deprojection.

Tip deprojection is a technically demanding procedure and requires thorough pre-operative planning. Changes to tip projection affect the entire nasal profile, and the consequences for the dorsum, tip rotation, and nasolabial angle must all be considered. Two consultations are always required before any rhinoplasty proceeds.

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Dr Jason Roth | MBBS, FRACS (ORL-HNS) | MED0001185485
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
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Dr Roth’s Clinical Perspective

Over-projection is one of the rhinoplasty concerns where the consultation discussion about proportions is particularly important. Reducing tip projection changes the nasolabial angle, the apparent length of the nose, and the relationship between the tip and the dorsum — and these changes need to be planned together rather than simply reducing projection in isolation. A tip that was previously over-projected but had good definition can look pinched or poorly supported if deprojection is not accompanied by appropriate structural management. I use computer imaging at consultation specifically for projection changes so patients can see the proportional consequences before any decision is made.

— Dr Jason Roth, MBBS, FRACS (ORL-HNS), IBCFPRS

Dr Jason Roth — Specialist Otolaryngologist Sydney

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Dr Roth consults from Dee Why on Sydney’s Northern Beaches. A minimum of two consultations is required before any rhinoplasty proceeds.

Dr Jason Roth (MED0001185485) — Specialist Otolaryngologist & Head and Neck Surgeon. All surgery involves risks and individual results vary.

Dr Jason Roth | MBBS, FRACS (ORL-HNS) | MED0001185485
Specialist Otolaryngologist & Head and Neck Surgeon
Specialist registration — Otorhinolaryngology, Head & Neck Surgery
View full profile | Rhinoplasty Surgery →
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