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Patel et al. Plast Aesthet Res 2024;11:20 Plastic and
DOI: 10.20517/2347-9264.2024.17
Aesthetic Research

Opinion Open Access

The excessively short nose: our systematic
approach

1
1
Priyesh N. Patel , Elizabeth Longino , Sam P. Most 2
1
Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, Vanderbilt University Medical Center,
Nashville, TN 37232, USA.
2
Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94304, USA.
Correspondence to: Dr. Sam P. Most, MD, Division of Facial Plastic and Reconstructive Surgery, Stanford University School of
Medicine, 801 Welch Road, Stanford, CA 94304, USA. E-mail: smost@stanford.edu

How to cite this article: Patel PN, Longino E, Most SP. The excessively short nose: our systematic approach. Plast Aesthet Res
2024;11:20. https://dx.doi.org/10.20517/2347-9264.2024.17

Received: 29 Jan 2024 First Decision: 9 May 2024 Revised: 22 May 2024 Accepted: 28 May 2024 Published: 31 May 2024
Academic Editors: Paolo Boffano, Stephen S. Park Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
The excessively short nose is a challenging dilemma in rhinoplasty. The variability in patient goals and nasal
anatomy prevents a one-size-fits-all approach, yet a collection of commonly employed techniques may be
considered when approaching an individual nose. This article discusses the common anatomical abnormalities
associated with a short nose and reviews the existing literature on techniques to address these abnormalities and
how they may be combined to create a unique surgical plan. Typically, correcting a short nose requires an increase
in nasal length and projection, along with a decrease in rotation. Achieving this necessitates a complete release of
the soft tissue and ligaments from all bony and cartilaginous attachments to allow for skin redraping, as the
mucosa and/or soft tissue envelope often pose limitations. Commonly employed techniques include a septal
extension graft, anterior septal reconstruction, lower lateral cartilage repositioning with grafting, tip grafts, and
occasionally composite grafts.

Keywords: Rhinoplasty, septoplasty, short nose, revision rhinoplasty

INTRODUCTION
The excessively short nose is among the most challenging dilemmas encountered in rhinoplasty, with a
[1]
number of anatomical nuances and variable etiologies . Disturbances in the soft tissue, mucosal lining, or

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
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