What Can Be Done to Reduce the Size of a Long Hook Nose? (photo)

I have what many call an aquiline/hook nose, it's very long with with a drooping tip and bump on the bridge. I am aware of nasal tip rotation and tip projection, but can i also have the anterior nasal spine removed/reduced to make my nose appear even shorter? would a plastic surgeon perform all these maneuvers? would my upper lip appear longer afterwards? i would of course love to remove the bump from my nose. any other tips on how to reduce vertical height would be great. thank you

Doctor Answers 6

The long nose with a dorsal hump is a common presentation and amenable to surgical correction.

You have already done some research obviously.  Yes, the dorsal hump needs to be eliminated (rasping and osteotomies) and the tip rotated up by trimming the tip cartilages.  This shortens the nose.  But this does not really involve the anterior nasal spine.  I prefer a closed approach, keeping the incisions on the inside of the nose where they cannot be seen.  Yes, an experienced plastic surgeon can combine these maneuvers.  Lifting the tip can make the upper lip appear longer, which is useful for those with a short upper lip.  There is a good example on my website, patient M.L.  I've attached a link.

Kansas City Plastic Surgeon
4.7 out of 5 stars 58 reviews

Reducing size of long hook nose

The rhinoplasty procedure would involve tilting the tip upwards with tip suturing techniques, cartilage removal, and dorsal hump removal.  Once the hump is removed, osteotomies will have to be performed to narrow the nasal bones.  These will all be done at the same time.  It is important not to remove the anterior nasal spine since this will just create more of a downward projection of the nose.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Rhinoplasty for a Drooping Nasal Tip

I would agree with your general description of what might be done to improve the appearance of your nose. However, as noted, the nasal spine would not be a real consideration in terms of rotating the tip and changing the tip projection. Instead, the emphasis would be more on repositioning and reshaping the lower lateral cartilages to achieve the desired goal. Your upper lip would likely be more visible afterwards, giving the illusion that it is longer. You could also have the bump reduced to give the profile a straighter appearance. I would highly recommend you find a board certified facial plastic surgeon who is experienced in this type of rhinoplasty work. I have included a link below to give you more information on this type of cosmetic nose reshaping. Happy healing.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.7 out of 5 stars 41 reviews

Reducing long hook nose

Thank you for your question and for providing the photos. There is a variety of things that can be done to change the appearance of the nose and make it more proportional to the rest of your face. The dorsal hump or bump could be removed, and the tip rotated back into position. This combination of manuevers will alleviate the hook shape of your nose. It is possible to shorten the nose at the same time. The bottom part of the septum, called the caudal septum, can be trimmed to shorten an overly long nose. This needs to be done conservatively, but can be quite effective.

Shortening the nose and elevating the tip will create more visibility of the upper lip, effectively making it appear longer. Based on your photos, I suspect that combining all of these aspects during an open rhinoplasty would greatly enhance the shape of your nose and bring it into balance with the rest of your face.

I would suggest a consultation with a board certified plastic surgeon that has experience with rhinoplasties. They should be able to answer any of your questions in detail after an examination.

Best of luck with your nose.

Jeff Rockmore

Jeffrey Rockmore, MD
Albany Plastic Surgeon
5.0 out of 5 stars 71 reviews

Rhinoplasty for the bulbous and overprojected tip with a hump.

Rhinoplasty for the bulbous and overprojected tip with a hump can be done. I agree that when the tip is rotated you indeed are overprojected. You have not seen your upper lip for years so it will appear longer even if it is 90 degrees to the face. See an experienced rhinoplasty surgeon .

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

What Can Be Done to Reduce the Size of a Long Hook Nose?

 Aesthetically speaking, from the photos provided, the nose is elongated (due to under-roatated nasal tip) with a large dorsal hump and wide tip.  These can be reduced and refined using a closed Rhinoplasty or Open Rhinoplasty.  If the tip is over-projected (I'm not sure that I agree aesthetically that it is from these photos), IMHO, it's best done at the level of the nasal tip by reducing the height of the tip cartilages themselves.  Removing the anterior nasal spine, as you have suggested, will not reduce projection but increase columellar retraction which is not indicated in this particular case.  Hope this helps. 

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 25 reviews

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.