Over-Projected Nasal Tip

Over-projection, defined as excessive protrusion of the nasal tip, can range from subtle and recognizable only to the most sophisticated eye to profound and immediately detectable to an untrained observer. Over-projected nasal tip, also termed “Pinocchio nose,” can be challenging to diagnose and correct even in the most experienced hands. Nasal tip over-projection involves overdevelopment of one or more individual anatomical components and is responsible for this common nasal deformity. However, underdevelopment of adjacent structures may result in an over-projected appearance to the tip (pseudo-over-projection). Familiarity with this latter appearance can avoid unnecessary tip deprojection by the surgeon. This chapter presents techniques that are used specifically to correct actual and pseudo-over-projection of the nasal tip.