The over projecting nose illustrates what happens when the cartilage structure of the nose becomes overgrown. It is not an ideal result as there remains some residual fullness and asymmetry on the left side of the nasal tip. The now apparent nasal hump was reduced and middle vault spreader grafts placed.Īt one year after surgery the dramatic improvement in the appearance of her nose could be appreciated. The septum was straightened and cartilage grafts harvested. Under general anesthesia and using an open rhinoplasty approach, the caudal end of the septum was resected and the lower alar cartilages shortened by a dome division/resection technique. She had a very long and thin nose that also had significant tip asymmetry due to buckling of the tip cartilages.
#PINOCCHIO NOSE RHINOPLASTY SKIN#
But thicker nasal skin patients may not have the same soft tissue response.Ĭase Study: This 43 year-old female presented for rhinoplasty surgery. Fortunately in many case of the over projecting nose the skin is thinner and does this fairly well. What happens to the now excessive skin depends on its natural ability to shrink back down to a smaller underlying supportive cartilage framework. While cartilage and bone can be reduced and reshaped, the same can not be said for the skin. Once the nasal tip is set back it often becomes evident that there is a nasal hump above the new lowered dorsal line that also needs to be addressed. This may or may not involve some degree of tip rotation. In essence this means that the the tripod cartilage unit at the end of the nose is resected and set back. The correction of the Pinocchio nose was originally described by a radical tripartite cartilage excision of the nasal tip and the subsequent reduction of the nose above it to fit the new tip position. These three cartilage structures merge at the nasal tip making the lower third of the nose look way out of proportion to the nose and face behind it. More anatomically described as an over projecting nose, it is the result of an elongated cartilaginous framework from the septum and lower alar cartilages. Such a description has been cited in plastic surgery articles all the way back to 1974. Background: The long protruding nose is well known in rhinoplasty and has been referred to as the ‘Pinocchio Nasal Deformity’.
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