Tip Projection Without Upturning the Nose - Revision Rhinoplasty?

Hello! I have to undergo my second revision rhinoplasty to project my nose (around 3-4mm) because my tip is too retracted and short for my facial features. I just want to project my tip without upturning it, and I don't know which is the most appropriate technique to achieve my desired outcome: caudal extension graft? columellar struts? any other option? Thank you in advance for your replies.

Doctor Answers 7

Tip Projection Without Upturning the Nasal Tip

Grafts are used for many purposes, and can help make both structural and functional improvements to the nose. A qualified surgeon will be able to tell what grafts will best help achieve your rhinoplasty goals. An in-person exam is really necessary to provide you with a recommendation on how you may improve your projection and which grafts would be appropriate based on your individual needs. The grafts you mentioned perform the following functions:

1) Columellar strut: used for support and straighten the nasal tip.  It can also be used to increase projection.
2) Caudal extension graft: can correct a short nose and increase projection.

I hope this helps, and good luck!

Charlotte Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

Revision Rhinoplasty for Nasal Tip Projection

There are several options to help increase the projection of your nose; however, balance of your nasal features and how they relate to the rest of your face is important to achieve a great result.  Please consult with a board certified specialist who can best help you achieve the results you seek.

Kimberly Lee, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 13 reviews

Tip Projection without Turning up Tip

It is impossible to answer your question without an examination or pictures. It is not clear what you want to correct, decreased projection or a short nose.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Proper Technique for Tip Projection

There are a number of techniques to increase the projection of your nasal tip.Without photos or a physical examination it is impossible to determine which techniques would be appropriate for your case.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

Tip projection

Generally speaking you will be looking at techniques to modify the underlying structure of your nose, particularly if you want to project and/or extend your nose tip. You are almost certainly going to need an open approach rhinoplasty (re-do nose and structural problems), and use of "caudal extension grafts" as you have noted.  I don't think that other options work very well.  As noted by other respondents, it is hard to know what specifically to do without seeing you and doing an examination in person.


Douglas J. Kibblewhite, MD
Vancouver Facial Plastic Surgeon

The exact choice of grafts depends on many factors

Dear misslila2

Sorry to hear that you are considering a second revision rhinoplasty.

  • You have listed two grafting techniques that may be used, but a variety of options exist. 
  • Your surgeon and you can discuss your desired changes and the potential grafting options, but please remember that choosing the kind of graft is only part of the recipe for success. 
  • Seek consultations to better understand the potential improvements and how likely that they can be achieved. 

Best Wishes


Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Adding tip projection

There are many different maneuvers to increase tip projection and this is really individually determined.  Hard to say without an exam.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 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.