The projection of the nose is a term used to describe how far out the nose comes from the face. However, just as the Eskimos have more than one word for snow, projection can have different meanings depending on the area in question.
The Types of Projection
Projection can be subdivided into the nasal tip and the nasal base of the nose. This difference in projection is often seen best on the base view of the nose (looking up at the bottom of the nose). Here the columella of the nose can be seen as well as the nasal tip. The base of the nose corresponds to the portion between the subnasale and the nasal tip, roughly the nasal columella.
The Columella vs. the Nasal Tip
Projecting through the columella has the advantage of avoiding tension along the columellar incision. Techniques to project through the base of the nose often involve placement of either a columellar strut or caudal extension graft.
Projection through the nasal tip can be important as well. Here the use of either intradomal sutures, nasal tip grafts, and support along the base can all influence the projection of the nose.
Measuring projection can help identify whether additional or less projection is complementary to the face. Keep in mind, that it is more important for the nose to fit the face than to rely on a numerical value guiding the surgeon.
Projection of the nose often is used interchangeably as well with support of the nasal tip. A supported nasal tip can lead the nasal profile allowing the surgeon to help contour the nasal dorsal profile based on this structure.
Rhinoplasty is the most complex plastic surgery procedure. This is in part due to the many nuances that play a role in nasal shape. All of these factors play a role in overall nasal tip appearance, making a “perfect nose” not obtainable for patients. However, improvement in several components of the nose can help lead to an enhanced, natural appearance of the nose.