PRS Plastic and Reconstructive Surgery · 2020

Rhinoplasty Refinements: Addressing the Deviated, Overprojected Nose

Rohrich RJ, Shanmugakrishnan RR, Mohan R.

What this paper says

A video case article showing correction of a crooked, over-projected nose with a bridge hump, using septal reconstruction and component dorsal hump reduction through the open approach.

Overview

Reducing a nose that projects too far, together with correcting the area just below the tip, is described by the authors as challenging and requiring a systematic approach. This article and its accompanying videos demonstrate that approach in a nose that is also crooked and carries a hump.

Sections of note

Deprojection of an over-projected nose and correction of an infralobular deformity are described as very challenging.
A systematic approach is stated to be needed for both.
A deviated nose with a dorsal hump is described as a common deformity.
The recommended treatment is septal reconstruction combined with the component dorsal hump reduction technique.
The open rhinoplasty approach is used.
The article and its videos show the correction of a deviated, over-projected nose with a dorsal hump.
No patient numbers, outcome measures, complication rates, or follow-up are reported.

What it means for a patient

Three problems are addressed in one operation: the nose being crooked, projecting too far, and carrying a bump.
Component reduction means the bone and cartilage parts of the hump are treated separately for control.
Rebuilding the septum is what straightens the nose; the hump reduction and deprojection follow from that.
This is a demonstration case with no measured outcomes, so it reports no results across patients.

Why this paper matters

The crooked over-projected nose combines several problems whose corrections interact, and video is how such sequences are taught. It records a current standard approach. It carries no evidence about outcomes or comparison with alternatives.

Terms

Deprojection: Reducing how far the tip stands out from the face.
Infralobular: The area of the nose just below the tip.
Deviated nose: A nose that sits off the facial midline.
Component dorsal hump reduction: Lowering the bridge by treating bone and cartilage separately.
Septal reconstruction: Rebuilding the central wall inside the nose to straighten and support it.

Summary written by rhinoplasty.cc from the abstract, 2026-09-09; not medical advice. The authors' own abstract follows.

From the abstract

“Deprojection of an overprojected nose and correction of an infralobular deformity are very challenging for rhinoplasty surgeons because a systematic approach is needed to correct these problems. A deviated nose with a dorsal hump is a common deformity that is best treated using septal reconstruction and the component…”

Excerpt; the full abstract is on PubMed.