Introduction: The long nose represents one of the most undesirable features in facial aesthetics leading to facial
disharmony. Despite being a common feature, review of the surgical literature shows that little attention has been given
to analyze and manage the long nose.
Aim: Identify the causes of long nose in the Egyptian population and proposed a surgical algorithm for correction of the
long nose deformity.
Patients and Methods: Fifty patients with long nose deformity were recruited in this study. Assessment to identify cause
of long nose in addition to pre-operative measurements of nasal length, projection, nasolabial and nasofrontal angles were
recorded and compared with the postoperative measurements after correction with the proposed algorithm.
Results: Multifactorial causes contribute to the long nose deformity. Most common cause in our study is lack of nasal
tip support in 94% of the cases, this was due to either long weak inferiorly oriented lower lateral cartilages in 35 patients
or short weak medial crura in 12 patients. 76% of the cases had an under-projected tip in association with the long nose
deformity. Our proposed surgical algorithm shows highly significant statistical difference between the pre-operative and
post-operative nasal length as well as nasal tip projection.
Conclusion: Multiple factors contribute to the long nose deformity. Egyptians most commonly have a long nose with
under-projected tip due to lack of nasal tip support. Following a Surgical algorithm in rhinoplasty is helpful stepwise
approach to plan for surgery however each operation must be tailored accordingly to each patient.