When viewing the nose from beneath, the nasal tip and nostrils form a triangle called the pyriform aperture. A nose surgeon will adjust the pyriform aperture to reduce the width of the nasal tip.

They can reduce the width of the nose by making the angles of this triangle steeper at the point where the nostrils attach to the face.

Board certified facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides rhinoplasty to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and surrounding locations.

Nasal Base Reduction

The nasal base reduction rhinoplasty technique can effectively reduce the width of the nasal base where it is too broad in comparison to other facial features. This technique is used in some variation as a routine part of rhinoplasty and revision rhinoplasty procedures.

Ethnic rhinoplasty patients undergo reduction of the nose base even more often. Patients with African American, Asian, and Middle Eastern lineage usually need nasal base reduction as these ethnicities typically have a wider nose base. To enhance the appearance of the nose, this area will require reduction.

Many patients considering rhinoplasty or revision rhinoplasty often complain that their nose appears too broad or large at the base. The base is measured from the outer margin of one nostril to the outer margin of the other.

Ideally, the width of the nasal base should not be more than the distance between the eyes. Upon visualizing a line extending vertically down from the corner of the eye, or inner canthus on either side, the nasal base should fall between these two lines.

But it is vital to understand that this adjustment is the aesthetic ideal for Caucasian rhinoplasty patients. This standard may not be appropriate for ethnic patients. Most ethnic nose reshaping cosmetic surgery patients attain optimal outcomes with a nasal base that is slightly wider than this ideal measurement.

Anatomy Involved In Nasal Base Reduction

To decide on the most appropriate surgical treatment of specific rhinoplasty patients, it is vital that the surgeon has an in-depth knowledge of the anatomy of the nose base area. The columella is the column-shaped structure that is found in the middle of the nasal base.

This structure bifurcates the nostrils into right and left parts. The alar base insertion is the part of the nostril side wall that attaches to the upper lip-cheek point. The nasal sill area lies between the alar base insertion point and the columella.

A Wide Sill Area

Along with a wide nasal base, some nose surgery candidates also tend to have a broad sill area that gives the nose extra width. An excessively broad sill could create a more horizontal type nostril shape. This is common in patients with a wide nasal sill.

What to Expect after Reduction Rhinoplasty Surgery?

Reduction rhinoplasty involves the same recovery period and strategies as other nose reshaping surgical procedures. Following the surgery, the patient will experience swelling and discomfort for a number of days as the nose, and the surrounding tissues heal.  

The bruising will subside gradually, and the swelling will resolve as the healing progresses. The final results of the rhinoplasty will establish over a period. The patient will be able to return to their routine activities after the recovery period.

Facial plastic and reconstructive surgeon Dr. Eric Yavrouian receives patients from Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and nearby areas for rhinoplasty.
For more information about treatments and procedures by Facial Plastic and Reconstructive Surgeon, Dr. Eric J. Yavrouian, serving patients in and around Glendale, Pasadena, Burbank and the Greater Los Angeles, CA area call 818-241-2150 or click here to contact him for a consultation.

It is apparent that the nasolabial angle consists of two lines when viewing the facial profile. The first line extends from the nasal tip to the area above the upper lip.

The second line runs from the upper lip to the bottom of the nose where the nostrils divide.

The Angle

The nasal projection and tip rotation affect the degree of the nasolabial angle. The surgeon will try to develop a 0- to 95-degree nasolabial angle in males and a 100- to 105-degree angle in females for most patients. Adjusting the projection and rotation of the nose can refine this angle.

Board certified facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides rhinoplasty to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and surrounding locations.

Adjusting the CLA

The columella-labial angle (CLA) is an important parameter to be evaluated in nose surgery patients to attain desirable results.

An increase in the CLA causes an upward tilt in the nasal base as well as an associated reduction in the length of the nose. This aspect is frequently overlooked due to diverse nose structures, and this leads to sub-optimal surgical results.

The columella and upper lip share a complex relationship. It is difficult to maintain a particular angle in rhinoplasty patients. Doing so involves various techniques such as nasal cartilage adjustments, suturing techniques, and cartilage grafts.

The caudal septum, nasal spine, and medial crura of the lower lateral cartilage influence the shape of the columella. For this reason, these factors contribute to determining the CLA.

The most aesthetically appealing columella-labial angle is 95 to 100 degrees in men and 100 to 110 degrees in women on profile view. The normal columellar display lies between two to four mm. If the columella hangs extensively, it can adversely impact the appearance of the nose in a significant manner.

Tent Pole Grafting

The ‘tent pole graft’ is an innovative technique used to set and preserve the columellar lip angle. This graft functions in a manner which is similar to the septo-columellar interpositional grafts.

To place the grafts, there is no need to dissect or delineate the upper lateral cartilages from the septum. The tent pole graft is used in difficult revision rhinoplasty procedures as well as cases there to tip projections needs to be increased significantly.

In this technique, the surgeon fixes a piece of cartilage to the columellar strut in the desired position. Then they determine the optimal angle by fixing the posterior end of the graft temporarily with a needle to the supratip cartilaginous dorsum.

After determining the CLA, the surgeon sutures the graft to the dorsum. The tent pole graft allows the extensive columellar strut to be stable and helps the tip not to fall back. This allows the benefits of maintaining the nasal tip and creating the desired CLA.  

A surgeon may use the tent pole technique when the tip needs support in revision rhinoplasty cases and for patients who require tip or columella lengthening. It is also a suitable technique for patients with short noses. This graft can be maneuvered to change the nasolabial angle or CLA easily.

The tent pole graft is particularly useful for patients who cannot undergo a septal extension graft or in cases where it is difficult to fix. For example, it can be appropriate for patients with mild to moderate short noses.

Facial plastic and reconstructive surgeon Dr. Eric Yavrouian receives patients from Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and nearby areas for rhinoplasty.
For more information about treatments and procedures by Facial Plastic and Reconstructive Surgeon, Dr. Eric J. Yavrouian, serving patients in and around Glendale, Pasadena, Burbank and the Greater Los Angeles, CA area call 818-241-2150 or click here to contact him for a consultation.

Nose projection is the distance that it projects outward from the point where it connects the upper lip to its tip.

If the tip is too protuberant, it can have a significant impact on the overall appearance of the nose. But if the nose under-projects, it will appear too shallow and excessively small relative to other facial characteristics.

The surgeon may trim away a portion of the cartilage at the nasal tip to reduce the projection of the nose. To increase the nose projection, the surgeon may separate and realign the cartilage.

A Surgical Step

They will push it forward and suture it into a refined position. If there is inadequate cartilage in the nasal tip, the surgeon may use a cartilage graft to augment it.

Board certified facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides rhinoplasty to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and surrounding communities.

Correcting an Over Projected Nose

Individuals with over-projected noses which protrude too far out from their face can undergo corrective surgery which involves trimming away the cartilage at the nose tip. This surgery, also known as nasal de-projection or retro-displacement, moves the nasal tip back to offer it a more attractive appearance.

Correcting an Under Projected Nose

The surgeon will extend the nose cartilage to re-project a nose which is under-projected. They can achieve this goal through two approaches, depending on the nasal anatomy. One approach involves shaving away the nasal cartilage and suturing it up to create a better nasal projection.

The second technique involves the surgeon taking a cartilage graft from another body area with adequate cartilage availability and using it to enhance the projection of the nose.

This donor cartilage is often taken from the nasal septum in cases of primary rhinoplasty. The cartilage can also be taken from the ears or the ribs if necessary.

Types of Cartilage Grafts

The cartilage grafts may be called columellar struts when used to support the columella which divides the nostrils. If the patient is undergoing a revision nose surgery, there may be inadequate septum cartilage.

Ear cartilage is quite elastic. For this reason, it is considered to be beneficial in providing support to the nasal tip. A common cartilage graft from the ear will be thicker relative to septum cartilage. But it may help develop a nose tip that feels more natural rather than one that is rigid and solid due to the elasticity.

Costal or rib cartilage is also considered a viable option for primary rhinoplasty patients. Ear or septal cartilage is commonly used in tip refinement. But at times, the surgeon may use rib cartilage as well.

Considerations for Male Patients

Men considering nose projection rhinoplasty may have concerns about their nose looking too feminine after the procedure. However, a judicious and skilled facial plastic surgeon can make sure that the male aesthetic of the nose is preserved while improving the nose projection simultaneously.

A nose projection surgery can effectively enhance the nose shape will preserving its masculine appearance for men who do not want to undergo a “full rhinoplasty.”

Facial plastic and reconstructive surgeon Dr. Eric Yavrouian receives patients from Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and nearby areas for rhinoplasty.
For more information about treatments and procedures by Facial Plastic and Reconstructive Surgeon, Dr. Eric J. Yavrouian, serving patients in and around Glendale, Pasadena, Burbank and the Greater Los Angeles, CA area call 818-241-2150 or click here to contact him for a consultation.

In case the nasal tip lacks definition or is too defined, it may not have a proper rotation. The upward or downward tilt of the nasal tip is called rotation.

The surgeon will reshape the cartilage to develop a more desirable nose tip. During this procedure, they will pay close attention to the nasal base as it impacts the tension and rotation.

Board certified facial plastic and reconstructive surgeon Dr. Eric Yavrouian provides rhinoplasty to patients in Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and surrounding locations.

What is Nose Tip Rhinoplasty?

Nasal tip rhinoplasty refers to a cosmetic surgery procedure undertaken on the lower third part of the nose. This is an intricate procedure where the rhinoplasty surgeon should be highly experienced and skilled as well as have an in-depth understanding of the nasal anatomy.

Nasal tip refinement is not only a cosmetic procedure but also a medical necessity at times. For instance, sometimes the patient may experience breathing issues either in their routine life or when sleeping because of an abnormally shaped nasal tip.

Sinus infections may also develop due to an abnormal nasal tip. Some patients also suffer from speech issues because of an abnormally shaped nose tip.

Reasons to Receive Tip Refinement

Nasal tip refinement can be undertaken either by itself or as an alternative to rhinoplasty for various reasons. However, patients usually undergo this procedure to correct a fuller or “bulbous” nasal tip.

Some patients may find that their natural nose structure to be unattractive such as patients with “hooked noses, noses that droop at the tip, or upturned noses. Nasal tip refinement has a slimming effect on the face in general.

Wide Tip Correction

A bulbous or wide nose often occurs because of a combination of thick nose skin and large nasal domes that are spaced apart widely. In many cases, a thick ligament or fat may separate the nasal domes.

The plastic surgeon will modify the soft tissue and move the domes closer to correct this condition. They may need to place a graft on the nasal tip itself for patients with thick skin to give the nose better definition. The surgeon may also shave off or tweak the cartilage structure beneath the skin to make the nasal tip narrower.

Less Invasive Procedure

The nasal tip refinement surgery is much less invasive in comparison to a full rhinoplasty. The inner structure of the nose undergoes significant modification in a traditional rhinoplasty. This may include fracturing the nasal bones which will lead to a longer recovery phase.

But nasal tip refinement usually involves only two to three incisions allowing the surgeon to access the cartilage in that area. The surgeon will seal the incisions after reshaping the nose. In addition, this procedure involves a relatively shorter recovery period.

For patients who are good candidates for tip refinement surgery, it usually offers a suitable alternative to “full” rhinoplasty surgery.

Facial plastic and reconstructive surgeon Dr. Eric Yavrouian receives patients from Glendale, Pasadena, Burbank, Greater Los Angeles, Beverly Hills, CA, and nearby areas for rhinoplasty.
For more information about treatments and procedures by Facial Plastic and Reconstructive Surgeon, Dr. Eric J. Yavrouian, serving patients in and around Glendale, Pasadena, Burbank and the Greater Los Angeles, CA area call 818-241-2150 or click here to contact him for a consultation.