Reducing the projection of a nose is one of the most common requests. When the projection of the nasal tip out from the face is reduced, this also causes the overall size of the nose to become smaller as the bridge on profile must reduce to avoid recreating an unpleasing dorsal bump. The amount of reduction depends on several things; how much the patient wants reduced, the thickness of the nasal skin, the skill of the surgeon, the degree of post rhinoplasty swelling, the amount of 'crowding' possible in side the nose, and the degree of risk the patient is will to assume.The usual limiting factor is the skin quality. The thinner the skin, the more the nose can be reduced. With thick skin, if the underlying supporting cartilage is over resected, thick skin is unable to shrink down and rap itself tightly to the smaller cartilaginous structure below. This then results in a shapeless, undefined nasal tip. An extreme example is the 'polly beak' deformity. Knowing how much reduction is too much reduction comes from good training, excellent surgical technique and long experience. Three very good reasons to seek out a skilled and experienced rhinoplasty surgeon.
