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Patel et al. Plast Aesthet Res 2024;11:20 https://dx.doi.org/10.20517/2347-9264.2024.17 Page 3 of 14

Table 1. Etiology of short noses

Congenital (e.g, Binder Syndrome)
Ethnic Variation
Traumatic (e.g., septal hematoma; damage to nasal framework or septum)
Neoplasm
Infection (e.g., septal abscess)
Inflammatory/ Autoimmune (e.g., Granulomatosis with polyangiitis)
Iatrogenic (post-surgical)

Figure 1. Disturbances in the external soft tissue, internal lining, or cartilaginous structure can result in a short nose. While variable,
common features of a short nose include a decreased nasal bridge distance from the nasofrontal angle to the tip defining points, an
increase in the nasolabial angle, retraction of the nasal ala, over-rotation of the nasal tip, and increased nostril show. The patients
shown here have variable etiologies of their nasal pathology, including trauma, prior rhinoplasty, inflammatory disease, and malignancy.

Figure 2. A number of nasal measurements can be used to delineate an ideal nasal length. Commonly, the length of the nose is
considered relative to nasal tip projection. Goode described this relationship through a ratio between the alar-facial groove to tip
defining point (projection) and from the nasion to the tip defining point (length). In an aesthetically pleasing face, this ratio should be
0.55-0.60.

of the nose. If deprojection of the nose is planned simultaneously, there may be excess skin to accommodate
the lengthening of the nose. If, however, a combination of lengthening and projection is necessary, the
patient should be counseled extensively on surgical limitations associated with the soft tissue. Attempts to
force soft tissue over a newly extended cartilaginous framework can place undue tension on the skin and
associated vascular plexus with resulting tissue necrosis. Similarly, if mucosa is placed on excessive stretch,
there can be resulting tissue breakdown and contracture at marginal incisions with resulting contracture of
the ala. Methods to address these issues are discussed below. While endoscopic examination or CT imaging