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

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.

Hello,A closed rhinoplasty is the best option for all of these procedures. By doing this via a scarless (closed) approach, there are no external cuts ever on your nose.  This prevents the dreaded complication of external scarring at the base of the nose, which even if rare, if it occurs, is devastating.  Through a scarless approach you can accomplish almost everything needed to be done to the nose with no scarring, less healing time, less bruising, and less swelling. All the best, Deepak Dugar, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

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.

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

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 .

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 with a closed rhinoplasty approach.  Digital computer imaging would be helpful to understand what can be accomplished with your nose upon your facial features.  It is important not to remove the anterior nasal spine since this will just create more of a downward projection of the 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.