The underprojecting nasal tip: an endonasal approach.

The consistent ability to gain and maintain nasal tip projection in the under projected nose is the trump card of the successful facial plastic surgeon. The underprojected nose is the nemesis that causes most of the disappointment in rhinoplasty for the patient and the surgeon. It is imperative that the surgeon recognize the many variations that constitute the underprojected nose, and this recognition must be made long before it is encountered in the operating room. The diagnosis of under projecting nasal tip is made by observation and by palpation. Several broad categories of nasal tips can be thought of as the underprojecting nasal tip family.