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The short nose

Lengthening the short nose is arguably the most difficult operation in aesthetic rhinoplasty. Dr. Sam Rizk, a NYC plastic surgeon, states that this challenging procedure has prompted him to develop and innovate new techniques and better ways to lengthen the nose using both grafting technology and implants and to decrease skin resistance to lengthening the nose. Dr. Sam Rizk, a New York facial plastic surgeon who specializes in primary and revision nose job surgery, emphasizes that the skin resistance is one of the most important aspects to overcome in lengthening the nose. But first it is necessary to examine the nose and decide how to determine if a nose is short.

Examination of the short nose

The length of the nose is the distance between two points, according to Dr. Sam Rizk, namely the nasion and the tip-defining point. The nasion is approximately the area of the nose between the eyes at the top part of the nasal bridge. The tip-defining point is the highest point of the tip of the nose. The normal nose has an approximate 5:3 ratio between the length and height of the nose. A short nose is one that has a length-to-height ratio that is less than 5:3. In these short noses, Dr. Sam Rizk further explains that there is a short distance between the nasion and the tip defining point. Dr. Rizk explains that absolute numbers are not adequate to determine nasal length because absolute numbers do not take into account other facial measurements such as facial length and width-some faces are so much longer than others. Therefore, when performing a nose job on a short nose, it is important to look at the ration instead. Dr. Rizk, a NYC expert, points to another important feature of a short nose-that of a long upper lip. Dr. Rizk sees this frequently in revision surgery, where the nose was overshortened surgically.

To summarize the above, Dr. Rizk recommends surgeons follow the following guidelines when determining a short nose:

1. An obtuse labio-columellar angle or nasolabial angle. (A normal angle for a man is 90 degrees, for females 95-100 degrees)
2. An over-projecting nasal tip.
3. A shallow slope of the dorsum and nasofacial angle. (Normal nasofacial angle is 34 degrees in women and 36 degrees in men)

Dr. Rizk points out that the above degree specifications are only guidelines and have to be put into perspective and analyzed on a case-by-case basis in relation to other facial features.

For more information on the Short Nose, please view:
Short Nose Open External Approach
Short Nose Grafts
Short Nose Techniques

  • Short Nose surgery - Before and After Fotos - front view
    Short Nose Techniques - Before and After Fotos - side view

    25 yo with history of previous rhinoplasty and is unhappy with scooped, short nose, with nostrils showing too much and a rotated up tip. Patient underwent revision rhinoplasty with Dr. Rizk using banked irradiated rib cartilage for grafts and Alloderm to soften the edges of the grafts. Dr. Rizk does not like to use the patient’s own rib due to scarring, risks to lung and danger to patient. Banked rib cartilage works excellent and has been used for many years in patients who are collapsed and need significant support. Patient is shown postoperatively at 1 year.