What Does Under Projecting Tip Mean?

I had a consultation with a surgeon,and he told me that I had an under projecting tip and dorsal hump. I was aware of the hump but I don't exactly know what he meant by under projecting tip? And what this exactly involves, surgically?

Please could you explain what this procedure involves and any considerations about my nose? He also said my nose slightly bends to one side and that my tip need refining.

I have since noted that one side looks bigger than the other, is this caused by the bend or shorter bones on each side? Please help. Thanks.

Doctor Answers 18

Nasal tip height and dorsal hump

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One theme in rhinoplasty is that creation of a harmonious result is paramount. In order to do this, one must assess all the features of the nose and face. In this instance, it sounds as if your surgeon has the opinion that the contour of the nose is being affected by not only how 'high' the bump is (dorsal hump), but also how 'low' the nasal tip is. The tip projection is measured by how far out it reaches from a line perpendicular to the vertical plane of the face.

Ideals on this vary, but it must be evaluated when looking at bringing the 'hump' down. For example, if the projection is too low and you lower the dorsum to match it, one may end up with an abnormally low, flat, long nose.

If you want more clarification, speak about this to your surgeon. If he/she does not explain this well, seek multiple opinions.

Hope this helps.

Bay Area Facial Plastic Surgeon
5.0 out of 5 stars 69 reviews

Dorsal Bump corrected with rhinoplasty

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Thank you for your inquiry!

It seems that you are a good candidate for a rhinoplasty that will improve the way your nose looks to complement your facial features in a natural fashion. Based on the description above, the under projection tip is only one aspect of the equation and the harmonious approach is the main goal. However, without a physical examination it is not possible to provide you with specific details. I highly recommend that you schedule a consultation with a well-experienced surgeon.

It is important to mention that the finest cosmetic results in any particular case are based on a variety of factors, including: the unique anatomy of the patient, realistic expectations, a well-informed and detailed discussion with your plastic surgeon concerning the best options for you especially covering a deep understanding of the pros and cons of any given choice you will adopt.

Please keep in mind that following the advice from a surgeon online who offers to tell you what to do without a physical examination covering the nature and the status of the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative solution would not be in your best interest. With that in mind, it is the safest and for your best interest to find a plastic surgeon with solid experience and certified by the American Board of Plastic Surgery who is ideally a member of the American Society of Plastic Surgeons that you will trust and be comfortable with. You should discuss your concerns with that surgeon in person.

Good luck!!!

Ali Sajjadian, MD FACS

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 205 reviews

Under projecting nasal tip means the tip is the lowest part of your nasal profile

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Thank you for your question.  It is generally considered ideal if on the side view the tip of the nose is the high point of the nose and the nasal bones are lower than the tip.  If the nasal tip is below the dorsal nasal profile it can be called and under projecting nasal tip or a hanging nasal tip.

Most plastic surgeons considered important to elevate the nasal tip in addition to lowering the nasal bump so that from the side view of the tip is the I point and the junction of the tip with the bone is called a break.

Correcting An Under Projected Tip (Doesn't stick out from the face far enough) in rhinoplasty?

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An underprojected tip can be addressed in many ways; but first you must make sure that your nasal tip is indeed underprojected.  A good rule is the distance from your upper lip to the base of your nose should be the same as the distance from the base of your lip to the nasal tip.  A bump on the bridge can also make your tip look underprojected.  The bottom line is that the tip of your nose should lead the nose, not the bump.  Cartilage reshaping and repositioning techniques aim to do just that and give the nose a more triangular look. 

Ramtin Kassir, MD
New York Facial Plastic Surgeon
4.7 out of 5 stars 179 reviews

Under projecting nasal tip

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Under projecting tip means the tip itself does not project far enough out from the face. Usually this is a result of a fallen or droopy tip and a very high dorsal cartilaginous hump. The under projecting tip may be fine once the hump is removed or it may need additional projecting with sutures and cartilage grafts. The nose can also be straightened and re-aligned with osteotomies after the hump is removed. Asymmetry in the nose is due to the long side and the short side of the nasal pyramid being twisted. Therefore the left and right quarter views are different, which gives a different profile.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Underprojected tip and Rhinoplasty

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One cannot evaluate the projection of the nasal tip without a side (profile) view. An under-projected tip means the tip is lower than your dorsum. However, if one has a dorsal hump and the hump is removed, the tip will then have normal or over-projection( depending on how much hump is removed). In other words, the projection of your nasal tip is relative to your dorsum.

I agree your tip has little definition and can be made more refined.

The goal of rhinoplasty is to give your nose balance from the top to the bottom. However, you should not expect perfect symmetry. Remember, if God or five billion years of evolution could not produce perfect symmetry in your face, it is unreasonable to expect a surgeon achieve such a goal in 3-4 hours!

Good Luck.

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Tip Projection

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Under projection means the tip does not adequately extend forward from the face. Removal of your dorsal hump will establish the position of your profile, one of the parameters used to determine proper tip projection. Deviation of your nose will cause the asymmetry you describe. All of these problems will be addressed with rhinoplasty surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Nasal tip projection

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Tip projection refers to how much the tip of the nose "sticks out" from your face when seen on the side view. In some cases, the nose itself is fine, but the chin may be too small, which makes the nose appear larger. The goal with any facial surgery is to bring your features into symmetry with each other. To reduce projection of the nasal tip, the cartilage can be reduced to bring the nose back a few millimeters. Good luck.

Nasal tip projection measures how far the tip sticks out from your face

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Nasal tip projection is just one factor out of many that makes an attractive nose. Projection in and of itself isn't as important as balance. Sometimes a tip can look weak yet look better by rotating it up or reducing a bump above it. I like using computer imaging to demonstrate projection and how increasing or decreasing it can change the way your nose looks.

Steven J. Pearlman, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 141 reviews

Under projecting tip

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This means that the tip of the nose isn't high enough to be aesthetically optimum. This is usually corrected with septal cartilage grafts which will give supprot and increased height or projection.

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.