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About Long Nose Rhinoplasty

People who desire long nose surgery typically have an overly projected nasal tip. This is also, and unfortunately, called “Pinocchio Nose.”

The goal in performing long nose surgery is to bring harmony to the facial features, making them proportionate, and ultimately guiding the gaze to your eyes. Dr. Hamawy does not believe that it should be obvious that the patient has had rhinoplasty. In fact, his personal approach is to make the nose harmonious in a way that others can’t remember a time when it looked otherwise. Last, but certainly not least, although long nose surgery is typically a cosmetic – not functional – procedure, the nose following surgery should function just as well if not better than before.

Nasal Anatomy

The nasal tip is created by two alar cartilages that sit on either side of the columella, which is the divider of skin and cartilage between the nostrils. People with an overly projected nasal tip have alar cartilages that extend too far beyond the columella. The two cartilages may also sit too high on the columella, creating a nose that is both long and pointy.


Long nose surgery involves shaving or trimming down the excess cartilage that extends past the columella. In some cases, the doctor may also have to reduce the size of the mucosa – the skin inside of the nose. If the cartilage sits too high on the nose, then it can also be repositioned to a more aesthetically pleasing position. It will be lowered and fixed in place.

This procedure can be performed either using the closed technique, where the incisions are hidden within the nostrils, or using the open technique, where an incision is made across the columella. The best technique will depend on the individual case and should be decided by a board certified plastic surgeon at the time of a consultation.

Additional Nose Shortening Techniques

In some cases, when performing long nose surgery, it will be necessary to perform additional rhinoplasty techniques in order to maintain proportion and harmony. For example, if you have large nostrils, minimizing the projection of the nose will only exacerbate the apparent size of the nostrils. In order to prevent this from happening we may need to decrease the size of the nostrils is through an alar base resection. This technique involves removing a wedge from the inside of each nostril and then closing them up with sutures. The incisions are made in a place where any scarring will be discreet. However, the best technique for you will depend on your unique anatomy.

Another common technique performed alongside long nose surgery is nasal tip rhinoplasty. This technique involves repositioning, reshaping, or grafting cartilage in order to make the tip of the nose more aesthetically pleasing. At this time, Dr. Hamawy can also address the angle between the tip of the nose and the upper lip.

Long nose rhinoplasty is a delicate surgery and should be performed by a surgeon who specializes in facial surgery and, therefore, is highly familiar with facial anatomy. The surgeon should also not only specialize in cosmetic plastic surgery, but also be comfortable in reconstructive surgery and all the underlying associated structures, like Dr. Hamawy. Contact Princeton Plastic Surgeons in Princeton, NJ today to request a consultation.

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