How To You Come To a Decision Regarding the Amount of Reduction for Overprojection?

In the case of an overprojecting nose, do you decide beforehand a definite number of millimetres to deproject it by (eg 4mm for one person, 6mm for another) or do you just have a general idea and then decide the exact amount during the surgery as you go?

Doctor Answers 8

Amount of Reduction for Overprojected Nasal Tip

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A surgeon will make a pre-operative decision regarding the amount of reduction of an overprojected tip on the basis of the projection of the bridge, the width of the tip, and the thickness of the skin. It is important to maintain proportion with the other nasal structures as well as other facial features. Find an experienced surgeon and review results in patients with noses like yours.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Rhinoplasty measurements are done BEFORE surgery

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The specific amount to remove during a rhinoplasty sure should be decided ahead of time! My process is straightforward but precise, I think. We first use computer imaging to help the patient and I see what would be aesthetically appropriate for their face and their concerns. From that imaging we use some custom software that I've written to determine exactly how much reduction or augmentation is needed at each point on the nose, from the root to the tip. Intra-operatively, I can refer to that output to make sure I'm following the blueprint, so to speak. Only minor intra-op finessing of those pre-planned amounts should be done if needed.

All the best,


David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

Decisions Made Before Rhinoplasty

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I always have a very good idea beforehand. Once the nose is injected and the rhinoplasty started, elements of judgement become very difficult due to swelling and other factors.


Surgeon's eye usually determines

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In general, there is not an accurate way to measure how much to set back the nose, or decrease projection. Pre operative computer imaging can be a good tool to aid communication between the patient and doctor. In the operating room, several manuevers can be performed with the nose to determine how much to remove. With experience, the correct amount can be removed in the first attempt. With less experience, it is safer to remove a conservative amount and take more if you need to. In general, inexperienced surgeons tend to take too much of the bridge and leave too much projection at the tip, creating a scoop. Each surgeon's experience and eye add into the ability to create a natural result. The most important consideration is to go to someone with a lot of experience and someone with whom you can communicate well.

John Alexander II, MD
San Diego Plastic Surgeon
4.8 out of 5 stars 13 reviews

Decisions during rhinoplasty

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There are ways to approach rhinoplasty by millimeters and proportions, and many of us will plan the dorsal reduction, and rotation by the numbers. For example, the nasal length to projection is 1:0.67. The final decisions comes down to the 'look' and balance of the nose overall. We find computer imaging and planning important to see ahead how things will work out, and to set a goal in mind.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

How To You Come To a Decision Regarding the Amount of Reduction for Overprojection?

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  How a plastic and cosmetic surgeon comes to a decision on how and what is done during any procedure or surgery, including Rhinoplasty depends on his/her sense of the aesthetics of beauty.  The most important factor in selecting your plastic and cosmetic surgeon for Rhinoplasty, Botox, Restylane, Face Lift or any other treatment to make you more attractive, IMHO, is their ability to understand and follow the proper aesthetics of facial beauty for the creation of a naturally, more attractive face...and in this case, Nose.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Rhinoplasty to improve facial appearance.

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Rhinoplasty to improve facial appearance depends on many factors including deprojection of the overprojected nose, including skin thickness, cartilage strength, etc. In general, good surgeons know roughly how much they want to deproject a tip along with the other variables before surgery.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Tip rhinoplasty

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Before surgery the surgeon has to examine the patient, measure the facial proportions and then plan the surgery. In general we want the bridge length to be 2/3 of the midface height and the projection of the tip out of the plane of the face to be 2/3 of the bridge length. That gives the patient aesthetic proportions. When we have those numbers we know how much to add or subtract from the medial crura (part of the tip cartilage in the strip of skin between the nostrils) to achieve the desired result.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.