Management of the short nose deformity in revision rhinoplasty.

The short nose is a complex and frustrating problem that many rhinoplasty surgeons face in their practice. It can be seen in both the hereditary nasal deformity patient as well as in patients having undergone previous nasal surgery. In the revision rhinoplasty patient, the short nose can result from overresection of the nasal dorsum, a deficiency in the middle third causing a saddle nose and tip retraction, and from structural loss in the lobule. Several methods have been described regarding the treatment of this deformity. They range from simple tip grafting in the mildly affected patient to complete nasal reconstruction in the patient with severe structural loss and skin retraction. We will discuss the anatomy of the short nose and describe our techniques for addressing specific deficiencies.