Nasal length is the distance between the nasofrontal angle and the nasal tip. Nasal length should be two thirds to three fourths of the midface height. A short nose is a result of not only a short nasal length but also excessive upturn of the nasal tip with too much nostril visibility. Some people are just born with a short nose. For example, short nose is very prevalent among Asians and African-Americans who do not have prominent nasal bridge or adequate nasal height. Short nose can also develop from complications of rhinoplasty or trauma. A saddle nose deformity with the collapse of the nasal dorsum and the upper lateral cartilages can result in the retraction of the nasal tip and thus shortening of the nose.
Likewise, aggressive resection of the lateral alar crura cartilage, dorsal septal cartilage, and the upper lateral cartilages can also result in upward rotation of the nasal tip, shortening of septal cartilage, and thus shortening of the nose.
Lengthening of the nose by a rhinoplasty specialist in Los Angeles entails several complex steps. Dorsal septal cartilage can be strengthened and lengthened with an extending spreader graft which is placed with an Open Rhinoplasty Technique. A columellar strut graft is used to extend the length of the tip of the nasal septum and thus to extend the nasal length. The integrity and the support of the nasal tip cartilages have to also be addressed. Excessive scarring of the nasal tip during a primary rhinoplasty can result in retraction of the nasal tip, even if the septal length is adequate. In this instance the tip cartilage framework can be strengthened with tip grafts, alar strut grafts, lateral crus grafts, etc. While lengthening of a short nose by revision rhinoplasty is possible it inherently carries risks of failure and complications, just like any other revision rhinoplasty surgery.
In cases of Asian and African American Rhinoplasty where nasal bridge is too flat and thus making the nose too short, the nasal bridge can be augmented with nasal implants, and/or nasal onlay cartilage grafts harvested from the septum, ear, or rib cartilage.