Projection and Deprojection Techniques in Rhinoplasty

Overview

Tip projection is described here as among the most important aspects of the nose. The article presents a range of manoeuvres a surgeon can use to move projection in either direction or to hold it where it is. The stated position is that a rhinoplasty surgeon must be competent in all three method families to achieve good long-term results.

Sections of note

• The article is a review chapter, not a study of patients.
• It covers techniques for decreasing, maintaining and increasing tip projection.
• The three method families named are suture techniques, lower lateral cartilage overlay techniques and structural grafting.
• Suture techniques reshape and reposition the existing cartilage without adding material.
• Overlay techniques shorten the tip cartilages by cutting and overlapping them.
• Structural grafting adds cartilage to support or push the tip forward. No patient numbers, complication rates or comparative outcome data appear in the abstract.

What it means for a patient

• Tip projection can be reduced as well as increased, and reduction is a distinct set of techniques rather than simply removing cartilage.
• Maintaining existing projection is treated as an active goal, because a tip left unsupported tends to drop after surgery.
• The methods differ in how much they alter the nose's own support, which affects how the result holds over time.
• This is a technique review without data, so it establishes what the options are rather than how often each succeeds.

Why this paper matters

Projection is one of the few dimensions of the nose that patients notice immediately and that surgeons struggle to hold steady over years. Grouping the available manoeuvres into three families gives a usable framework for planning. Which family gives the most durable result, and in which noses, is not settled by a review of this kind.

Terms

• Nasal tip projection: how far the tip of the nose stands out from the face.
• Deprojection: surgically reducing that forward projection.
• Suture technique: reshaping cartilage by stitching it into a new position without adding graft material.
• Lower lateral cartilage: the paired cartilages that form and support the nasal tip.
• Overlay technique: cutting and overlapping cartilage to shorten it.
• Structural grafting: adding cartilage pieces to build support into the nose.